This two day nursing seminar is ideal for those working in aged care, palliative/end of life care or other concerned health professionals who assist patients with chronic pain conditions on a routine basis. The purpose of the program is to offer a forum for nurses to update their skills relating to the management of persistent pain and advanced cancer pain in adults.
If you have identified a professional need to improve your understanding of advanced and persistent pain management as part of your planned learning activities, then this program will offer you an opportunity to gain continuing professional development (CPD) hours related to this topic.
Need for Program
As the population continues to age, more people require complex health support, this includes assistance with the management of chronic pain. As new evidence continues to emerge about the best way to manage persistent and advanced cancer pain, it is essential that nurses have access to up-to-date information that will ensure the care they provide is relevant and correct. As well, nurses are required to gain a minimum of 20 CPD hours relevant to their context of practice.
Aims and Objectives
This program enhances nurses knowledge about how to care for people with persistent and advanced cancer pain. The seminar will include complex case studies.
At the completion of this seminar participants will be conversant in the following:
Clearly define pain demonstrating a knowledge of the different types of
adult pain and why it is important to differentiate between them.
Describe the reasons why the pain experience is a unique phenomenon
that requires a tailored response to care.
Demonstrate knowledge of the nursing care of a person who is experiencing
two different types of pain simultaneously.
Be able to clearly document pain management in a competent and
concise manner.
Day 1
Day 2
Educators
8.30am - Registration and Refreshments
9.00am - About Chronic Pain and How it Differs to Acute Pain
Revision of important concepts:
Definition of Pain.
Pain thresholds in different individuals - an overview of pain mechanisms and pathways, and sensitizing or modulating factors.
Fears and anxieties: the psychological impact of pain on people.
10.30am - Morning Tea and Coffee
11:00am - Nursing Assessment - The Golden Key to Effective Persistent Pain Management
How do the signs and symptoms of chronic pain differ from those encountered in acute pain?
Which assessment tools and skills ensure that a comprehensive pain assessment has been undertaken?
How often should chronic pain be re-assessed?
Comments of documentation of your assessment findings including:
Documenting your reports to other members of the multi-disciplinary team.
Documenting the impact of persistent pain on the activities of daily living.
12:15pm - Long-Term Pain Management - Principles, Policies and Dilemmas
What is meant by the term "therapeutic window"?
How do you know when someone who cannot communicate and who you believe is in pain, is well managed?
What can be done about intractable pain?
Discussion of types of chronic pain and nursing management interventions.
Examples of clinical dilemmas and possible solutions.
1:00pm - Lunch Break and Time to Network
2:00pm - Analgesias Used for Chronic Pain
Discussion of a range of analgesia and allied medications, which may be prescribed for reducing pain. What are the benefits and risks of the use of patient-controlled-analgesia?
Ointment, tablet or pump – how are decisions made about which form of analgesia to administer? Comments on common side effects/ complications.
What is meant by a co-analgesic or opioid-sparing analgesic?
3.00pm - Afternoon Tea and Coffee
3.30pm - Case Studies and Group Work
Three small group case studies to formulate suggested management options for a variety of scenarios in persistent pain management. These Include:
Lower back pain - arthritis.
Neuropathies e.g. diabetic neuropathy,
Post-herpetic neuralgia i.e. Shingles
4.15pm - Close of Day One
Start of Day Two
9.00am - Introduction to Pain in the Patient with Advanced Cancer
Incidence in patients with advanced cancer – one pain or many?
Causative factors – disease process, treatments, general illness factors.
The presence of suffering due to pain or an aggravating factor?
Why some cancer pains ache and others burn – nociceptive v neuropathic or both types of pain.
General overview of cancer pain terminology.
9.30am - Pain Assessment - The Fifth Vital Sign
Taking a comprehensive history – physical, social, emotional, psychological and spiritual – all important factors in cancer pain management.
Characteristics of the pain, provocative and palliative factors.
Review of the use of validated pain assessment tools.
Outline of the difference between acute, chronic, incident pain and the various pain syndromes in cancer disease.
Documentation Considerations
How to document beyond the numeric rating scale.
Documenting your reports to other members of the multi-disciplinary team.
Documenting the impact of cancer pain on the activities of daily living.
10.30am - Morning Tea and Coffee
11:00am - Pricinples of Cancer Pain Management and Goals of Treatment
General principles of medication management of cancer pain:
Negotiating patient centred goals of analgesia.
Opioids– in depth review of opioid drugs, methods of administration, dose titration and equianalgesic dosing.
Management of opioid induced side effects.
Non-opioid drugs and adjuvant medications.
Dosing considerations in the elderly.
What to do when analgesia is not successful?
12:30pm - Lunch Break and Time to Browse the Book Display
1:30pm - More Management Options
Review of interventional procedures/ blocks and treatments for tumour debulking and pain reduction.
Physical and psychological therapies.
Complementary therapies and their role in cancer pain management.
Pain management devices and implantable therapies.
Relaxation and distraction techniques.
Management of impaired sleep.
3.00pm - Afternoon Tea and Coffee
3.30pm - Case Studies and Group Work
Small group case studies to formulate suggested management options for a variety of scenarios in advanced cancer patients:
Prostate cancer – e.g. bone, bowel and bladder related pains
Lung cancer – e.g. brain, bone and nerve plexus related pains
Breast cancer – e.g. bone, brain and liver related pains
4.15pm - Close of Day Two and Evaluations
Dale Long
Dale has worked in various cancer care, palliative care and pain management roles, in inpatient and domiciliary settings for the past 24 years, in both Victoria and Queensland. She is an experienced presenter with a strong commitment to educating nurses to improve the quality of pain management delivered to patients. She is currently working at Peter MacCallum Cancer Institute in Melbourne and she is a Member of the Australian Pain Society.
