• Chronic Pain Management With Opioids: An Assessment of Alaska Nurse Practitioner Practices

      Klein, Stephanie (University of Alaska Anchorage, 2016-05-01)
      The purpose of this project was to determine chronic opioid pain management practices of Alaskan Nurse Practitioners (NPs) in primary care, compare them to best practices, and describe perceived barriers to evidence-based guideline use. Participants included NPs in Alaska who work in primary care and currently have an active Alaska NP license and Alaska mailing address. This project answered the questions of to what extent primary care NP practices are consistent with current Federation of State Medical Boards (2013) guidelines when managing chronic non-cancer pain with opioid therapy as well as identified the perceived barriers to guideline use. A cross sectional, descriptive design was used. The principal investigator mailed a paper survey to a convenience sample of NPs in Alaska. Nurse practitioners in Alaska follow guidelines when initiating opioid therapy most of the time, with all but three guidelines being followed ‘very frequently’ by at least 50% of respondents. Respondents follow guidelines less often when managing opioid therapy with only one guidelines being followed ‘very frequently’ by at least 50% of respondents. Two major barriers to guideline use include resource and knowledge barriers. The findings of this project were used to make clinical recommendations for improved practice.
    • Management of Pain During Intrauterine Device Insertion

      Booysen, Debra (University of Alaska Anchorage, 2016-05-01)
      Increased use of intrauterine contraception is desirable to achieve safe, highly effective, long-acting, and reversible means to prevent unintended pregnancy. For most women, intrauterine device (IUD) contraception is a viable option for protection from an unplanned pregnancy. Fear of pain during insertion is one barrier to IUD use. The aim of this project was to identify best practice evidence for different types of interventions for the management of pain during IUD insertion. Evidence for pain management strategies was critically appraised, and the most recent information synthesized into evidence-based recommendations to promote point-ofcare decisions.