Oral presentation given at the International Council of Nurses 23rd Quadrennial Congress, May 2005, Taipei, Taiwan

Kane, H. Lynn

Krenzischek, Dina A.

Wilson, Linda, 1962-

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Development of the 
ASPAN
Pain and Comfort 
Clinical Guideline 
Linda Wilson RN, PhD, CPAN, CAPA, BC
Dina Krenzischek RN, MAS, CPAN
H. Lynn Kane RN, MSN, MBA, CCRN
Consensus Process
●Descriptive Study (Survey)
–Survey of Perianesthesia Nursing 
Practice on PACU Pain and Comfort 
Management
Consensus Process
●Pre-Consensus Conference
–August 3-5, 2001 Philadelphia, Pa.
●Pain & Comfort Experts
–Chris Pasero (Pain Expert)
–Linda Wilson (Comfort Expert)
●National Leaders 
Consensus Process
●Consensus Conference
– January 12-13, 2002  Nashville, TN.
●ASPAN (American Society of Perianesthesia 
Nurses)
●ASA (American Society of Anesthesiologists)
●AANA (American Association of Nurse 
Anesthetists)
●JCAHO  
●Pain & Comfort Experts
●National Leaders
●75 State Representatives
Pain & Comfort 
Clinical Guideline
●Development of the guideline
– Addressed phases of perianesthesia 
care
●Pre-operative phase
●Post operative phase
– Post anesthesia Phase I 
– Post anesthesia Phase II
– Post anesthesia Phase III 
Pain & Comfort 
Clinical Guideline
●Development of draft of the guideline
– Addressed perianesthesia care in all 
phases
●Assessment
●Interventions
●Expected outcomes
Pain & Comfort 
Clinical Guideline
● IRB Approval
– Johns Hopkins Hospital, Baltimore MD
●Pilot test of guideline
– Revisions made based on results of pilot
●Research testing of the guideline
– Clarity, Usability, Feasibility
– Multi-site / Multi-state Research Study
Pain & Comfort 
Clinical Guideline
●Completion of testing of the guideline
●Analysis of results
●Guideline formatted and printed
●Board of Directors and Representative 
Assembly approval
●Endorsement of Guideline
– American Society of Anesthesiologists
●Development of Resource Manual
Pain & Comfort 
Resource Manual
● Pain and Comfort Clinical Guideline
● Pain and Comfort Management 
Competency
● Interventional Pain Therapies Competency
● Advanced Comfort Management 
Competency
● Pediatric Pain Management Competency
● Geriatric Pain Management Competency
Pain & Comfort 
Resource Manual
●Practical Guides
– Legal
– Documentation
– Integrative Therapies
– Culturally Diverse Patients
– Special Considerations
Pain & Comfort 
Resource Manual
●Educational Resources
– Patient & Family Teaching Guide (English 
& Spanish)
– Relaxation Exercises
– Patients Talking About Pain (English & 
Spanish)
– Clinician’s Teaching Guide
– Questions & Answers for Clinicians
– Frequently Asked Questions by 
Perianesthesia Nurses
Pain & Comfort 
Clinical Guideline
●National Guidelines Clearinghouse
– Guideline submitted and accepted
●Guideline also available as a free 
download from the ASPAN website  
www.aspan.org
References
● Krenzischek, D., Wilson, L. (2003). An Introduction to the 
ASPAN Pain and Comfort Clinical Guideline. Journal of 
Perianesthesia Nursing, 18 (4).
● Wilson, L. & Kolcaba K. (2004). Practical Application of 
Comfort Theory in the Perianesthesia Setting. Journal of 
Perianesthesia Nursing, 19 (3). 
● Krenzischek, D., Wilson, L., Newhouse, R., Mamaril, M., 
Kane, H. L., (2004). Clinical Evaluation of the ASPAN 
Pain and Comfort Clinical Guideline. Journal of 
Perianesthesia Nursing, 19 (3).
● Krenzischek, D., Windle, P., Mamaril, M. (2004). A Survey 
of Current Perianesthesia Nursing Practice on Pain and 
Comfort Management. Journal of Perianesthesia Nursing, 
19 (3).
Suggestions for 
Future Research
● Impact of the guideline on patient 
outcomes
●Application of the guideline to acute 
care clinical areas outside of the 
perianesthesia setting
●Application of the guideline to patients 
not in the acute care setting
●Re-testing of the guideline after 
updates and modifications


Development of the ASPAN pain and comfort clinical guideline

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