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TRAINEESHIP PRECEPTORS
Albert R. Barber, PharmD, CGP, FASCP
Director of Pharmacy
Golden Living
Janice M. Scheufler, PharmD, FASCP
Clinical Pharmacist
Hospice of the Western Reserve
TRAINEESHIP SITES
Hospice of the Western Reserve, Cleveland, Ohio
Hospice of the Western Reserve provides palliative end-of-life care, caregiver support, and bereavement services throughout Northern Ohio. The focus of hospice and palliative care is pain management, symptom control, and emotional, psychosocial and spiritual support for the patient, caregiver and family. Its purpose is to enhance quality of life and provide dignity in the final days.
Heartland of Mentor, Mentor, Ohio
Heartland of Mentor is a comprehensive medical and rehabilitation center serving the care needs of a wide variety of patients, including short-term post-acute care and long-term care.
CURRICULUM
As a regular part of their experience, participants will meet daily with at least one of the preceptors and other members of the interdisciplinary team at the clinical practice sites to participate in patient rounds, assessment, and care planning for patients with acute or chronic pain. Participants will also interact directly with patients on a daily basis to observe pain symptoms and discuss a holistic plan of care with special emphasis on medication choices and outcomes monitoring, medication responses and other management issues. Participants will actively engage in discussions on management of selected patients as well as case studies submitted in advance of the traineeship by participants. In addition to the long-term care facility and the hospice inpatient facility, participants may interact with patients in the home or pain clinic.
The traineeship will utilize four basic educational components, but will focus heavily on the experiential/clinical components. The scheduling of these components will be determined by daily practice site schedules and patient availability.
Didactic/Discussion Sessions
- Introduction to hospice and palliative care
- Methadone
- Effective Communication with patients and caregivers and with other care team professionals
- Neuropathic pain
- Complementary therapies: massage, art and music
- Barriers to pain management
- The role of physical therapy
- Persistent malignant and nonmalignant pain
- Pain management and family/patient dynamics
- Quality Indicators, Quality Measures and Five Star quality ratings for pain management in nursing facilities
- Pain assessment and management in the cognitively impaired resident
- Other relevant clinical care issues will be discussed as encountered
Experiential/Clinical
- Follow patients with chronic or acute pain while establishing a plan for assessment, implementation and monitoring, and the pharmacologic and nonpharmacologic management of pain.
- Interact with interdisciplinary teams for the care of patients with chronic malignant and nonmalignant pain syndromes.
- Participate on rounds with physicians, pharmacists, and nursing facility staff while performing pain assessments, care planning, and individualizing pain management needs.
- Observe and interact with residents, home care patients, caregivers, and family members.
- Learn and observe atypical or nonverbal signs of pain among persons with cognitive impairment and how to appropriately assess and manage their pain.
- Observe and perform patient assessments for acute and chronic pain for persons with and without cognitive impairments.
- Experience the emotional, spiritual, psychological, and medical challenges (holistic approach) that occur when a chronic pain state impacts the entire health of a geriatric patient.
- Identify and experience barriers to pain management in individual patients.
Case Discussions
- Traineeship participants are required to submit one case study from their practice for discussion during the traineeship. Case studies submitted in advance of the traineeship by participants will be presented and discussed throughout the week with preceptors and selected members of the interdisciplinary team.
- Participants will interview patients and work up cases for presentation and discussion.
- Other selected patient cases highlighting acute and chronic pain conditions and clinical care decision making will be discussed throughout the week.
Selected Reading
Selected reading materials, which will be provided to participants prior to the traineeship, include more than 30 required and recommended articles on a broad rand of pain management topics such as: pain assessment, bone pain, chronic pain, pain guidelines, neuropathic pain, use of NSAIDs, rheumatoid/osteoarthritis, fibromyalgia, patient-controlled analgesia, pain in dementia, and pain management for older adults.
The intent of the Pain Management Traineeship pre-reading is to solidify a foundation of learning based on current literature, evidence, and standards of practice. Participants are encouraged to review and read these articles based on their knowledge level and learning goals.
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