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his issue of ECPN will focus on pain management. As the authors point out, pain is highly prevalent among the elderly. One author reports that as many as 60–80% of nursing home residents have persistent pain, and nearly half of community-dwelling adults over the age of 65 report pain severe enough to interfere with normal activities.
       In our cover story, Peter Winn, MD, CMD, and Rita Hancock, RN, CHPN, state the goals of pain management as “to increase each resident’s level of independence to the highest practicable physical, mental, and psychosocial well being” and “to prevent the potential adverse consequences.” The authors emphasize the importance of effective pain management that includes recognition, assessment, treatment, and monitoring. This comprehensive overview of pain management begins with a definition of pain and continues through the causes of pain in long-term care, classification of pain, recognition of polypharmacy, avoidance of analgesic medications, and more. At the conclusion, the authors list a number of helpful websites.
       Another feature, “Testing a New Pharmacy Services Model,” is not solely focused on pain management but touches on the adverse effects of the pain medication propoxyphene. In this article, the author, Janice L. Feinberg, PharmD, JD, describes the Fleetwood Project, a 3-phase initiative launched to define the role of the consultant pharmacist in improving patient outcomes and reducing healthcare costs. The last of its 3 phases, powered by intervention, has several key components, including nurse alert cards for inappropriate medications. These cards were developed to foster early recognition of potential adverse drug effects of propoxyphene and medications with anticholinergic effects.
       Cynthia A. Fleck, RN, BSN, MBA, ET/WOCN, DAPWCA, CWS, FCCWS, takes an in-depth look at the pain experienced by patients with wounds in “Dressing to Reduce Pain.” Ms. Fleck notes that it is important to assume that all wounds are painful and every patient with a wound is in pain. She offers pain relief, dressing selection, and treatment hints, emphasizing that dressing removal is considered to be the time of most pain for patients, as stated in the European Wound Management Association position statement.
       Additionally, our Outcome and Assessment Information Set (OASIS) columnists, Pamela Teenier, RN, MBA, CHCE, COSC, and Ben Peirce, RN, BA, CWOCN, have devoted this month’s column to pain. Here, the authors focus on the OASIS questions related to pain assessment, specifically M0420 (frequency of pain interfering with patient’s activity or movement) and M0430 (intractable pain).
       Finally, as I sign off this issue, I also sign off as Managing Editor for ECPN. Since November 2004, I have been working closely with ECPN Senior Editor Ryan Dougherty. With the close of this issue, Ryan will assume the role of Managing Editor and serve readers in the same capacity as I have over the past few years. You may send correspondence to Ryan at ryand@hmpcommunications.com or you can reach him at 800-237-7285, extension 265. Reader feedback remains a crucial element in the planning of ECPN, and your feedback is welcome.
       As always, I hope you enjoy this issue of ECPN.