Course Code: REL-PAC-ELNEC-CMPMANGMT
Hours: 2.25
Type: Online Course
Content Expiration Date: 12/31/2029
Learning Objectives:
Identify three barriers to adequate pain relief in serious illness for patients across the life span.
Recall two components of a thorough pain assessment.
Identify two pharmacological and two nonpharmacological therapies used to relieve pain.
Recognize the role of the nurse involved with pain assessment and management in serious illness.
Outline:
Section 1: Introduction to Pain Management
Pain and Pain Treatment
Pain Is…
Cancer and Pain
Non-Malignant Disease and Pain
Pain in the Critical Care Area
Effects of Unresolved Pain
Barriers to Pain Management
Healthcare Professionals
Healthcare Systems
Patients and Family Caregivers
Overcoming Barriers
Education of Healthcare Professionals
System-Based Issues
Pain Assessment
Pain Management
Education of Patients and Family Caregivers
Research
Clinical Practice Guidelines
Goals of Pain Management
Pain Versus Suffering
Consider This
Patients at Risk for Undertreatment
Older Adults
Children
Patients Who Are Nonverbal, Cognitively Impaired, or Unconscious
Patients Who Deny Pain
Patients Who Are Non-English Speaking
Patients Who Are Uninsured and Underserved
Patients From Different Cultures
Patients with Substance Use Disorder (SUD)
Review
Key Takeaways
Section 2: Pain Assessment
Communication
Pain Experience
Meaning
Comorbid Conditions
Pain Assessment
Pain History
Patients in Critical Care Areas
Foci of Pain Assessment
Location
Intensity
Quality
Temporal Factors
Aggravating/Alleviating Factors
Past and Current Therapies
Use of Other Substances
PQRST
Physical Assessment
Observation
Examine
Palpation
Auscultate
Percussion
Functional Assessment
Functional Status
Laboratory and Diagnostic Evaluation
Unable to Self-Report
Pain Etiology
Nociceptive Pain
Neuropathic Pain
Acute Verus Chronic Pain
Pain Assessment and Management Vignette
Discussion Questions
Communicating Assessment Findings
Reassess
Communicating Pain Assessment Findings
Review
Key Takeaways
Section 3: Pain Management
Setting the Stage for Pain Management
Overview
Non-opioids
NSAID Adverse Effects
Opioids
An Equianalgesia Table for Medication Comparison
Buprenorphine
Methadone
Benefits for Pain
Conversion Ratio
Titration
QTc Effects
Drug Interactions
Opioids in Critical Care
Adverse Effects of Opioids
Respiratory Depression
Constipation
Other Adverse Effects
Sedation
Urinary Retention
Nausea and Vomiting
Pruritus
Myoclonus
Other Reactions
Substance Use Disorder (SUD)
Pain in People With SUD
Tolerance and Physiologic Dependence
Adjuvant Therapy
Antidepressants and Anticonvulsant Medications
Topical Medications
Corticosteroids
Cannabis
Case Study
Routes of Administration
Transdermal and Topical Delivery
Parenteral and Spinal Delivery
Review
Key Takeaways
Section 4: Principles of Pain Management
Opioid Dose Titration
Opioid Rotation and Equianalgesia
Putting It All Together: Pain Assessment Interview
Treatment of Pain in People with SUD
Principles of the Treatment of Pain in People with SUD
A Safe Approach to Treatment
Other Issues With Pain Management
Polypharmacy
Cost
Compounding
Interventional Therapies
Neurolytic Blocks
Neuroablative Procedures
Vertebroplasty and Kyphoplasty
Cancer Therapies for Pain Relief
Nonpharmacological Strategies
Review
Key Takeaways
Section 5: Conclusion
Course Summary
Course Information
Course Contributors
Resources
References
Subject Matter Expert: 2026 ELNEC Core Series
The content for this course was written by The ELNEC Project Team.
The ELNEC Project, which began in 2000, is a collaboration between City of Hope, Duarte, CA and the American Association of Colleges of Nursing (AACN), Washington, DC. For more information about ELNEC, go to www.aacnnursing.org/ELNEC
The content for this course was revised by Constance Dahlin, MSN, ANP-BC, ACHPN®, FPCN, FAAN.
Constance Dahlin has focused her career within hospice and palliative care. Connie serves as national faculty for the End-of-Life Nursing Education Consortium (ELNEC). She has practiced palliative care across the health continuum: home, clinic, long-term care, rehabilitation, and acute care settings. She has administered hospice, home health, and palliative care programs. She has created education for program development, academic curricula, and interprofessional team education.
Currently, Ms. Dahlin is a palliative nurse practitioner at MGB Salem Hospital. She is faculty at University of Maryland Baltimore PhD, MS, and Graduate Certificate in Palliative Care. She is a consultant and senior nurse advisor to the Center to Advance Palliative Care (CAPC) with a focus on community-based care and education. She is co-director of the Palliative APP Externship at the Medical University of South Carolina. She serves on the American Hospital Association Circle of Life Award Committee, the Massachusetts Network for Community-Based Care, and the Massachusetts Comprehensive Cancer Steering Committee.
Ms. Dahlin has authored many peer-reviewed articles, chapters, and curricula. She has presented nationally and internationally. Ms. Dahlin is co-editor of the Oxford University Press Advanced Practice Palliative Nursing 1st and 2nd editions. She edited and authored four editions of the Palliative Nursing: Scope and Standards and three editions of the Competencies for the Palliative and Hospice RN, and APRN. She wrote the Hospice and Palliative APRN Professional Practice Guide and A Primer of Reimbursement, Billing, and Coding: Essential Information for the Hospice and Palliative APRN. She referenced the 2004 first education of the National Consensus Project’s Clinical Practice Guidelines for Palliative Care and edited the 2009 and 2013 editions.
Ms. Dahlin is a Fellow of Hospice and Palliative Nursing, a Fellow of the American Academy of Nursing, a 2005 Certified ACHPN APRN of the year, a 2016 Sojourns Cambia Health Foundation Sojourns Leadership Scholar Award Recipient, a 2018 American Academy of Hospice and Palliative Medicine Visionary in Hospice and Palliative Medicine, the 2020 Hospice and Palliative Nursing Association Distinguished Practice Award and the 2021 University of Maryland Baltimore Program in Palliative Care Teacher of the Year. She completed her MSN in oncology nursing and her post-masters in adult primary care at the MGH Institute of Health Professions.
Target Audience:
The target audience for this course is: Advanced Practice Nurses; Nursing Personnel; in the following settings: Hospice.
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To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.