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| 1 | Using quality improvement methods to increase use of pain prevention strategies for childhood vaccination显示文摘AIM To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology.METHODS Specific intervention strategies(i.e.,comfort positioning,nonnutritive sucking and sucrose analgesia,distraction) were identified,selected and introduced in three waves,using a Plan-Do-Study-Act framework.System-wide change was measured from baseline to post-intervention by:(1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and(2) caregiver satisfaction ratings following the visit.Additionally,self-reported staff and caregiver attitudes and beliefs about pain prevention were measured at baseline and 1-year post-intervention to assess for possible long-term cultural shifts.RESULTS Significant improvements were noted post-intervention.Use of at least one pain prevention strategy was documented at 99% of patient visits and 94% of caregivers were satisfied or very satisfied with the pain prevention care received.Parents/caregivers reported greater satisfaction with the specific pain prevention strategy used [t(143) = 2.50,P ≤ 0.05],as well as greater agreement that the pain prevention strategies used helped their children's pain [t(180) = 2.17,P ≤ 0.05] and that they would be willing to use the same strategy again in the future [t(179) = 3.26,P ≤ 0.001] as compared to baseline.Staff and caregivers also demonstrated a shift in attitudes from baseline to 1-year post-intervention.Specifically,staff reported greater agreement that the pain felt from vaccinations can result in harmful effects [2.47 vs 3.10; t(70) =-2.11,P ≤ 0.05],less agreement that pain from vaccinations is 'just part of the process' [3.94 vs 3.23; t(70) = 2.61,P ≤ 0.05],and less agreement that parents expect their children to experience pain during vaccinations [4.81 vs 4.38; t(69) = 2.24,P ≤ 0.05].Parents/caregivers reported more favorable attitudes about pain prevention strategies for vaccinations across a variety of areas,including safety,cost,time,and effectiveness,as well as less concern about the pain their children experience with vaccination [4.08 vs 3.26; t(557) = 6.38,P ≤ 0.001],less need for additional pain prevention strategies [3.33 vs 2.81; t(476) = 4.51,P ≤ 0.001],and greater agreement that their doctors' office currently offers pain prevention for vaccinations [3.40 vs 3.75; t(433) =-2.39,P ≤ 0.05].CONCLUSION Quality improvement methodology can be used to help close the gap in implementing pain prevention strategies during routine vaccination procedures for children. | Jennifer Verrill Schurman Amanda D Deacy Rebecca J Johnson Jolynn Parker Kristi Williams Dustin Wallace Mark Connelly Lynn Anson Kevin Mroczka | 2017 | World Journal of Clinical Pediatrics2017，6，1： | 3 |
| 2 | Metabonomics: a platform for studying drug toxicity and gene function显示文摘 | Nicholson JK Connelly J Lindon JC Holmes E | 2002 | Nat Rev Drug Discov2002，1，2： | 2 |
| 3 | Multiwavelength activelymode-locked fiber ring laser with a dispersion compensatedcavity 显示文摘 | O’Riordan C Connelly M J | 2010 | Optics Communications2010，283，9： | 1 |
| 4 | Dynamic-susceptibility contrast agent MRImeasures of relative cerebral blood volume predict response to bevacizumab in recurrent high-grade glioma显示文摘 | Schmainda KM Prah M Connelly J | 2014 | Neuro Oncol2014，16，3： | 1 |
| 5 | Metabonomics: a platform for studying drug toxicity and gene function显示文摘 | Nicholson J K Connelly J Lindon J C | 2002 | Nat Rev Drug Discov2002，1，2： | 1 |
| 6 | Metabonomics: a platform for studying drug toxicity and gene function显示文摘 | Nicholson JK Connelly J Lindon JC | 2002 | Nat Rev Drug Discov2002，1，2： | 1 |
| 7 | Metabonomics:a platform for studying drug toxicity and gene function显示文摘 | Nicholson J K Connelly J Lindon J C | 2002 | Nat Rev Drug Discov2002，1，2： | 1 |
| 8 | Metabonomics:a platform for studying drug toxicity and gene function显示文摘 | NICHOLSON J K CONNELLY J LINDON J C | | 0，，： | 1 |
| 9 | Adiponectin in a native Canadian population experiencing rapid epidemiological transition 显示文摘 | Hanley A J Connelly PW Harris SB | 2003 | Diabetes Care2003，26，12： | 1 |
| 10 | Time-resolved fluorescence imaging of photosensitiser distributions in mammalian cells using a picosecond laser line-scanning microscope 显示文摘 | Connelly J P Botchway S W Kunz L | 2001 | J Photoch Photobio A2001，142，23： | 1 |
| 11 | Metabolic syndrome and its components as predictors of incident type 2 diabetes mellitus in an Aboriginal community显示文摘 | Ley Sylvia H Harris Stewart B Mamakeesick Mary Noon Tina Fiddler Edith Gittelsohn Joel Wolever Thomas M S Connelly Philip W Hegele Robert A Zinman Bernard Hanley Anthony J G | 2009 | Canadian Medical Association. Journal2009，，6： | 1 |
| 12 | Movements,survivals and reproductions of Sage Grousetranslocated in to central Idaho显示文摘 | DAVID D M CONNELLY J W REESE K P | 1993 | Wildl Manage1993，57，1： | 1 |
| 13 | Composition-structure Relationships in Simplified Nuclear Waste Glasses:Mixed Alkali Borosilicate Glasses显示文摘 | Connelly A J Travis K P Hyatt N C | 2011 | Journal of the American Ceramic Soeiety2011，94，1： | 1 |
| 14 | Modeling of nonlinear polarization rotation in tensile-strained semiconductor optical amplifiers using mueller matrices and carrier density induced refractive in- dex change calculations显示文摘 | Connelly M J | 2013 | Optics Communications2013，308，： | 1 |
| 15 | A noise-based IC random number generator for applications in cryptography 显示文摘 | Petrie C S Connelly J A | 2000 | IEEE Transactions on Circuits and Systems I: Fundamental Theory and Applications2000，47，5： | 1 |
| 16 | Metabonomics:a platform for studying drug toxicity and gene function显示文摘 | NICHOLSON JK CONNELLY J LINDON JC | 2002 | Nat Rev Drug Discov2002，1，2： | 1 |
| 17 | Metabonomics: a platform for studying drug toxicity and gene function 显示文摘 | Nicholson JK Connelly J Lindon JC | 2002 | Nat Rev Drug Discov2002，1，2： | 1 |
| 18 | The role of bisphenol A in shaping the brain, epigenome and behav- ior显示文摘 | Wolstenholme J T Rissman E F Connelly J J | 2011 | Horm Behav2011，59，3： | 1 |
| 19 | Metabonomics: a platform for studying drug toxicity and gent function显示文摘 | Nicholsen JK Connelly J Lindon JC et ol | 2002 | Nat Rev Drug Discov2002，1，2： | 1 |
| 20 | Literature andmedicine:contributions to clinicalpractice显示文摘 | Charon R Trautmann J Connelly J et a1 | 1995 | Annalsof lnlemalMedicine1995，，8： | 1 |
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