Pain Management Nursing
Volume 9, Issue 3 , Pages 131-140 , September 2008

Nurses' Opinions on Appropriate Administration of PRN Range Opioid Analgesic Orders for Acute Pain

  • Debra B. Gordon, RN-BC, MS, CNS-BC, FAAN

      Affiliations

    • Hospital & Clinics, University of Wisconsin, Madison
    • Corresponding Author InformationAddress correspondence to Debra B. Gordon, RN, MS, FAAN, University of Wisconsin Hospital & Clinics, 600 Highland Avenue–6727, Madison, WI 53792
    • ,
  • Teresa A. Pellino, RN, PhD

      Affiliations

    • School of Nursing, University of Wisconsin, Madison
    • ,
  • Gerry Ann Higgins, MSN, RN-BC, OCN

      Affiliations

    • Inova Alexandria Hospital, Alexandria, Virginia
    • ,
  • Chris Pasero, MS, RN-BC, FAAN

      Affiliations

    • Pain Management Education and Clinical Consultancy, El Dorado Hill, California
    • ,
  • Kathleen Murphy-Ende, RN, PhD, AOCNP

      Affiliations

    • Hospital & Clinics, University of Wisconsin, Madison

References 

  1. American Pain Society (APS). Principles of analgesic use in the treatment of acute pain and cancer pain. 5th ed.. Glenview, IL: APS; 2003;
  2. American Pain Society Quality of Care Committee. Quality improvement guidelines for the treatment of acute pain and cancer pain. JAMA. 1995;274(23):1874–1880
  3. Boer C, Treebus AN, Zuurmond WWA, de Lange JJ. Compliance in administration of prescribed analgesics. Anaesthesia. 1997;52:1177–1181
  4. Chassin MR, Galvin RW. The urgent need to improve health care quality. JAMA. 1998;280(11):1000–1005
  5. Dahl JL, Gordon DB. The JCAHO standards: a progress report. American Pain Society Bulletin. 2002;12(6):1–1112
  6. Gordon DB, Dahl JD, Phillips P, Frandsen J, Cowley C, Foster RL, et al. The use of “as-needed” range orders for opioid analgesics in the management of acute pain: A consensus statement of the American Society for Pain Management Nursing and the American Pain Society. Pain Management Nursing. 2004;5(2):53–58
  7. Hanks GW, DeConno F, Cherny N, Hanna M, Kalso E, McQuay HJ. Morphine and alternative opioids in cancer pain: The EAPC recommendations. British Journal of Cancer. 2001;84:587–593
  8. Harris JT, Kumar KS, Rajagopal MR. Intravenous morphine for rapid control of severe cancer pain. Palliative Medicine. 2003;17:248–256
  9. Howell D, Butler L, Vincent L, Watt-Watson J, Stearns N. Influencing nurses' knowledge, attitudes, and practice in cancer pain management. Cancer Nursing. 2000;23(1):55–63
  10. Institute for Safe Medication Practices (ISMP). Pain scales don't weigh every risk. Medication Safety Alert!. 2002;7(15):1–2http://www.ismp.org/MSAarticles/pain.htmWeb site: (retrieved October 13, 2007)
  11. Joint Commission (JC). Comprehensive Accreditation Manual for Hospitals (CAMH), Update 1. Oakbrook Terrace, IL: JC; 2007;
  12. Mercadante S. Opioid titration in cancer pain: a critical review. European Journal of Pain. 2007;11:823–830
  13. McCaffery M, Pasero C, Ferrell BR. Nurses' decisions about opioid dose. American Journal of Nursing. 2007;107(12):35–39
  14. Pasero C, Manworren RCB, McCaffery M. IV opioid range orders for acute pain management. American Journal of Nursing. 2007;107(2):52–59
  15. Pasero C, McCaffery M. Monitoring opioid-induced sedation. American Journal of Nursing. 2002;102(2):67–68
  16. Pasero C, Portenoy RK, McCaffery M. Opioid analgesics. In:  McCaffery M,  Pasero C editor. Pain: clinical manual. 2nd ed.. St. Louis: Mosby; 1999;p. 161–299
  17. Taylor S, Voytovich AE, Kozol RA. Has the pendulum swung too far in postoperative pain control?. The American Journal of Surgery. 2003;186:472–475
  18. Titler MG, Herr K, Schilling ML, Marsh JL, Xie XJ, Ardery G, et al. Acute pain treatment for older adults hospitalized with hip fracture: Current nursing practices and perceived barriers. Applied Nursing Research. 2003;16(4):211–227
  19. Upton RN, Semple TJ, Macintyre PE. Pharmacokinetic optimization of opioid treatment in acute pain therapy. Clinical Pharmacokinetics. 1997;33(3):225–244
  20. Vila H, Smith RA, Augustyniak MJ, Nagi PA, Soto RG, Ross TW, et al. The efficacy and safety of pain management before and after implementation of hospital-wide pain management standards: is patient safety compromised by treatment based solely on numerical pain ratings?. Anesthesia and Analgesia. 2005;101:474–480

PII: S1524-9042(08)00072-6

doi: 10.1016/j.pmn.2008.03.003

Pain Management Nursing
Volume 9, Issue 3 , Pages 131-140 , September 2008

Article Tools

* Image Usage & Resolution