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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 | Seeing I to I : A Pathway to Interpersonal Connectedness 显示文摘 | Pinel Elizabeth C Long Anson E Landau Mar J Alexander Kira Pyszczynski Tom | 2004 | Journal of Personality and Social Psychology2004，90，2： | 1 |
| 3 | The Gelation and Crystallization of Amylopeetin 显示文摘 | Stephen G Ring Paul Colonna Kenneth J I' Anson | 1987 | Carbohydr Res1987，162，： | 1 |
| 4 | Four - dimensional visualization of construction scheduling and site utilization 显示文摘 | Chau K W Anson M Zhang J P | 2004 | Construction Engineering and Management2004，130，4： | 1 |
| 5 | Effect of Hydrogen Content on Relative Shrinkage and Gas Mieroporotity in Al-7% Si Casting 显示文摘 | Anson J P Gruzleski J E | 1999 | AFS Transactions1999，107，： | 1 |
| 6 | Novel Pseudomonas plasmid involved in aniline degradation显示文摘 | Mackinnon G | 1984 | Appl Environ Micobiol1984，48，： | 1 |
| 7 | High level expres- sion nf the phenylalanine ammonia lyase encoding gene from Rho- dosporicium toruloides in Saccharomyces cerevisiae and Escherichia coli using a bifunctional expression system 显示文摘 | Faulkner J D B Anson J G Tuite M F | 1994 | Gene1994，143，1： | 1 |
| 8 | Some aspects of anion-induced adsorption of white metal cations on mercury显示文摘 | Barclay D J Anson F C | 1970 | J Electroanal Chem1970，28，： | 1 |
| 9 | Seeing I to I : A Pathway to Interpersonal Connectedness 显示文摘 | Pinel Elizabeth C Long Anson E Landau Mar J Alexander Kira Pyszezynski Tom | 2004 | Journal of Personality and Social Psychology2004，90，2： | 1 |
| 10 | Reduction of O2 to H2O2 as catalyzed by cobalt ( Ⅱ ) Tetrakis (4-N-methylpyridyl) porphyrin显示文摘 | Anson F C Ni Ching-long Saveant J M | 1985 | J Amer Chem Soc1985，107，： | 1 |
| 11 | The effects of shading on morphometric and meristic characteristics of wild celery,Vallisneria americana,transplants from Lake Okeechobee,Florida显示文摘 | Havens K E Sharfstein B Steinman A Anson D East T Maki R P Rodusky A Jin K R | 2002 | Arch Hydrobiol2002，155，： | 1 |
| 12 | High-inten- sity cycle interval training improves cycling and running per- formance in triathletes显示文摘 | ETXEBARRIA N ANSON J M PYNE D B | 2013 | Eur J Sport Sci2013，14，6： | 1 |
| 13 | Identification of periodic marks in paper and board by image analysis using two-dimensional fast Fourier transforms-Part 2: Forming and press section marks 显示文摘 | I'Anson S J | 1995 | Tappi Journal1995，78，7： | 1 |
| 14 | The anatomy of the pelvic autonomic nerves in relation to gynecology 显示文摘 | Curtis AH Anson B J Ashley FL | 1942 | Surg Gynecol Obstet1942，73，： | 1 |
| 15 | Electrochemistry of the Cu(II) complex of 4,7 - diphenyl - 1,10 - phenanthrolinedisulfonate adsorbed on graphite electrodes and its behavior as an electrocatalyst for the reduction of O2 and H2O2 显示文摘 | Zhang J Anson F C | 1992 | Journal of Electroanalytical Chemistry1992，341，12： | 1 |
| 16 | A modeI of c8theter-associatedurinary tract infection initiated by bacterial contamination of the catheter tip显示文摘 | Barford J M Anson K Hu Y | 2008 | B J U Int2008，102，1： | 1 |
| 17 | B-cell deficit and increased B-cell apopotosis in humans with type 2 diabetes显示文摘 | Butler AE ]anson J Bonner-Weir eta/ | 2003 | Diabetes2003，52，： | 1 |
| 18 | Beta-cell deficit and in creased beta-cell apoptosis in humans wit h type 2 diabetes显示文摘 | Butler AE J anson J Bonner-Weir S | 2003 | Diabetes2003，52，1： | 1 |
| 19 | Proprioceptive performance of bilateral upper and lower limb joints: side-general and site-specific effects显示文摘 | Han J Anson J Waddington G | 2013 | Exp Brain Res2013，226，3： | 1 |
| 20 | A model of catheter-associated urinary tract infection initiated by bacterial contamination of the catheter tip显示文摘 | Anson K Hu Y | 2008 | B J U Int2008，102，1： | 1 |
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