a middle range theory: chronotherapeutic intervention for postsurgical pain
DESCRIPTION
A Middle Range Theory: Chronotherapeutic Intervention for Postsurgical Pain. Theory developed by Susan E. Auvil -Novak By Candice Kiskadden. Overview Objectives. Discuss the theory of Chronotherapeutic Intervention for postsurgical pain (CIPP) Describe purpose and major concepts of CIPP - PowerPoint PPT PresentationTRANSCRIPT
A Middle Range Theory:
Chronotherapeutic Intervention for
Postsurgical PainTheory developed by Susan E.
Auvil-Novak
By Candice Kiskadden
Overview ObjectivesO Discuss the theory of Chronotherapeutic
Intervention for postsurgical pain (CIPP)O Describe purpose and major concepts of CIPPO List contexts for use of the CIPP theoryO Discuss nursing implications of CIPPO Characterize the evidence of empirical
testing of CIPPO Outline current research articles using CIPPO Communicate application to author’s practice
Theory of Chronotherapeutic Intervention for Postsurgical Pain
O CIPP theory states pain management is time dependent
O “Chronotherapeutic” approaches to pain
O Derived from theory, literature review, and studies
O Used three separate studiesO Analgesic utilization is a feedback
loop for pain reception
Who is Susan E. Auvil-Novak?
O Authored four publications related to nursing
O Publication focus was on time aspects
Susan E. Auvil-Novak, Ph.D, RN
Analysis and Evaluation
CIPP Theory
Purpose and Major Concepts
O Prescriptive Mid-range Nursing Theory
O Focused on postoperative pain perception
O Pain is chronologically rhythmicO Different pain interventions needed
at different levels through cycleO Maximize pain control and minimize
adverse effects
Context for UseO Theory has evidenced-based practice
references to past studiesO Clinical evidence supports theory of CIPP
pharmacologic administrationO Can be applied to different types of pain stimuliO Uses model of Individual Biologic Time StructureO Use of CIPP pain management enhances
postoperative outcomesO Can be used for populations unable to verbally
communicate: children, neonates
Nursing ImplicationsO Recent studies support congruency with
CIPP TheoryO Patient controlled analgesics currently
utilized postoperativelyO Theory is socially relevant and can be
applied transculturallyO Increases the nursing evidence-based
practice for pain controlO Heathcare professionals can provide better
pain control with less adverse effects
Evidence of Empirical Testing
O Empirical validation of gynecologic oncology patients
O Compounding evidence supported the theory in three separate studies
O Testing has proved the theory to be accurate and valid
O CIPP has been cited in many other scholarly publications
Research Utilizing CIPP
O Henly, S. J., Kallas, K. D., Klatt, C. M., & Swenson, K. K. (2003). The notion of time in symptom experiences. Nursing Research, 52(6), 410-417.
O Sherwood, G. D., McNeill, J. A., Starck, P. L., & Disnard, G. (2003). Changing acute pain management outcomes in surgical patients. AORN Journal, 77(2), 374-395.
Henly, Kallas, Klatt, & Swenson
O Appropriately uses CIPP Theory to build new SET theory
O Uses theory to build on nursing practice
O Uses CIPP theory as empirical study to illustrate critical points
O Does not continue to develop CIPP theory
O Relevant to current evidence-based nursing practices
Sherwood, McNeill, Starck, & Disnard
O Appropriately uses CIPP theory to increase research knowledge
O Supports hypothesis of postoperative pain management
O Contributes to chronotherapeutic approach of pain assessment
O Contends that CIPP theory enhances postoperative outcomes and precipitate recovery
Practice ApplicationO No direct application to Operating
Room nursingO Preoperative assessment can include
CIPP for greater pain managementO Effective for immediately
postoperativeO OR nurses and CRNAs can influence
prescriber for order of CIPP
ReferencesAuvil-Novak , S. E. (1997). A middle-range theory of chronotherapeutic intervention for postsurgcial pain. Nursing Research, 46(2), 66-71. Retrieved from http://www.nursingcenter.com/lnc/JournalArticle?Article_ID=102327
Henly, S. J., Kallas, K. D., Klatt, C. M., & Swenson, K. K. (2003). The notion of time in symptom experiences. Nursing Research, 52(6), 410-417. Retrieved from http://www.nursingcenter.com/lnc/journalarticle?Article_ID=443674
McEwan, M., & Wills, E. M. (2011). Theoretical Basis for Nursing (3rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Sherwood, G. D., McNeill, J. A., Starck, P. L., & Disnard, G. (2003). Changing acute pain management outcomes in surgical patients. AORN Journal, 77(2), 374-395. Retrieved from http://www.aornjournal.org/article/S0001-2092(06)61206-4/fulltext