Epidural Analgesia Update

Course #30873 - $30 -

Overview

Evidence has shown that epidural analgesia is more effective than systemic narcotics in the management of acute pain for a variety of postoperative populations, including trauma procedures, thoracotomy, upper abdominal surgery, and orthopedic procedures. Benefits of the epidural route for the administration of pain management medications include improved analgesia with longer lasting pain relief using fewer doses and less sedation, resulting in earlier restoration and improvement in pulmonary function, decreased metabolic-stress response, and earlier ambulation. The purpose of this continuing education activity is to educate acute care nurses and surgical staff about the use of epidural analgesia as a method of pain control.

Education Category: Medical / Surgical
Release Date: 04/01/2021
Expiration Date: 03/31/2024

Table of Contents

Audience

This course is designed for nurses and allied surgical staff in postoperative areas including recovery, critical care, oncology, neurology, orthopedics, and obstetrics.

Accreditations & Approvals

In support of improving patient care, NetCE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. NetCE is accredited by the International Accreditors for Continuing Education and Training (IACET). NetCE complies with the ANSI/IACET Standard, which is recognized internationally as a standard of excellence in instructional practices. As a result of this accreditation, NetCE is authorized to issue the IACET CEU.

Designations of Credit

NetCE designates this continuing education activity for 5 ANCC contact hour(s). NetCE designates this continuing education activity for 5 pharmacotherapeutic/pharmacology contact hour(s). NetCE designates this continuing education activity for 6 hours for Alabama nurses. NetCE is authorized by IACET to offer 0.5 CEU(s) for this program. AACN Synergy CERP Category A.

Individual State Nursing Approvals

In addition to states that accept ANCC, NetCE is approved as a provider of continuing education in nursing by: Alabama, Provider #ABNP0353, (valid through July 29, 2025); Arkansas, Provider #50-2405; California, BRN Provider #CEP9784; California, LVN Provider #V10662; California, PT Provider #V10842; District of Columbia, Provider #50-2405; Florida, Provider #50-2405; Georgia, Provider #50-2405; Kentucky, Provider #7-0054 through 12/31/2025; South Carolina, Provider #50-2405; West Virginia RN and APRN, Provider #50-2405.

Course Objective

The purpose of this course is to educate acute care nurses and allied surgical staff about the use of epidural analgesia as a method of pain control in a variety of settings.

Learning Objectives

Upon completion of this course, you should be able to:

  1. Describe the historical evolution that preceded the use of epidural analgesia as a method of pain management.
  2. Review spinal anatomy, including differences between the epidural and subarachnoid spaces.
  3. Identify key points in patient selection and preparation for epidural analgesia.
  4. Discuss the action of epidural narcotics.
  5. Compare the advantages and disadvantages of the various epidural administration methods.
  6. Outline patient safety considerations applicable to the administration of epidural analgesia.
  7. Discuss physiologic parameters to assess in a patient receiving epidural analgesia.
  8. Describe narcotic- and catheter-related side effects/complications of epidural analgesia and appropriate nursing interventions.
  9. Discuss common nursing diagnoses and interventions for the patient receiving epidural analgesia.

Faculty

Margo A. Halm, RN, PhD, NEA-BC, received an Associate Degree of Nursing in 1981 from Iowa Central Community College, a BSN and Master of Arts in Nursing from the University of Iowa, in 1985 and 1987 respectively, and a PhD from the University of Minnesota in 2005. She is a member of the American Association of Critical Care Nurse's, and Sigma Theta Tau International. Dr. Halm has presented nationally and internationally, coauthored articles, and conducted nursing research studies on topics such as epidural analgesia, complementary therapies, women and heart disease, family presence during resuscitation and other family-centered interventions. Currently, Dr. Halm practices as the Associate Chief Nurse Executive of Nursing Research and Evidence-Based Practice at the VA Portland Health Care System in Portland, OR.

Faculty Disclosure

Contributing faculty, Margo A. Halm, RN, PhD, NEA-BC, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Division Planner

Jane C. Norman, RN, MSN, CNE, PhD

Division Planner Disclosure

The division planner has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Director of Development and Academic Affairs

Sarah Campbell

Director Disclosure Statement

The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

About the Sponsor

The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.

Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.

Disclosure Statement

It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.

Technical Requirements

Supported browsers for Windows include Microsoft Internet Explorer 9.0 and up, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Supported browsers for Macintosh include Safari, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Other operating systems and browsers that include complete implementations of ECMAScript edition 3 and CSS 2.0 may work, but are not supported. Supported browsers must utilize the TLS encryption protocol v1.1 or v1.2 in order to connect to pages that require a secured HTTPS connection. TLS v1.0 is not supported.

Implicit Bias in Health Care

The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.

Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.