scholarly journals Improving the Quality of Care for Acute Pain Management in Recovery Room at the Georgetown Public Hospital Corporation

2019 ◽  
pp. 13-14
Author(s):  
Dorette Husbands-Anderson ◽  
Jennifer Szerb ◽  
Alexandra Harvey
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Health Care Professionals ◽  
Assessment Tool ◽  
Standards Of Care ◽  
Average Dose ◽  
Management Intervention ◽  
Pain Medications ◽  
Post Operative Pain ◽  
Pain Intervention

Objectives: To observe the method of pain assessment and pain management intervention performed by nurses in the PACU. Methods and Design: A QI prospective observational study was conducted to observe nurse’s pain assessment and management of thirty (30) patients from the time of PACU admission to discharge. The sample size was determined using the sealed envelope power calculator. Data Collection Included: patients demographics, the method and frequency of pain assessments as well as modalities of the pain intervention and the type and average dose of pain medications administered by PACU nurses. Data analysis was done using Microsoft excel. Results: No validated pain assessment tool was used in the PACU.  The majority of patients 67%, n=20) had no pain assessments or pain interventions. When performed, the frequency of pain assessments recorded were low, 70% of patients had 1-2 assessments. The principal pain management intervention was pharmacological with the use of opioids, accounting for 96%. Conclusion: Post-operative pain management in the PACU at GPHC does not meet accepted standards of care. More frequent nursing pain assessment using a validated pain assessment tool is required. Monotherapy with the opioid was the main pain intervention for pain management. Recommendations: Effective pain management begins with the appropriate pain assessment; therefore pain management education programs for health care professionals are essential. Also, the implementation of a standardized pain assessment tool, a standardized post anesthetic order sheet with a multimodal approach to pain management and restructuring the post-anesthetic record to allow for documentation of pain assessment will greatly improve pain management in the PACU.

Pain Assessment and Management in Critically Ill Intubated Patients: a Retrospective Study

2004 ◽  
Vol 13 (2) ◽  
pp. 126-136 ◽  
Author(s):  
Céline Gélinas ◽  
Martine Fortier ◽  
Chantal Viens ◽  
Lise Fillion ◽  
Kathleen Puntillo
Keyword(s):  
Pain Management ◽  
Critically Ill ◽  
Pain Assessment ◽  
Assessment Tool ◽  
Quebec City ◽  
Pharmacological Interventions ◽  
Relieve Pain ◽  
Self Reports ◽  
Data Collection Instrument ◽  
Pain Documentation

• Background Little research has been done on pain assessment in critical care, especially in patients who cannot communicate verbally.• Objectives To describe (1) pain indicators used by nurses and physicians for pain assessment, (2) pain management (pharmacological and nonpharmacological interventions) undertaken by nurses to relieve pain, and (3) pain indicators used for pain reassessment by nurses to verify the effectiveness of pain management in patients who are intubated.• Methods Medical files from 2 specialized healthcare centers in Quebec City, Quebec, were reviewed. A data collection instrument based on Melzack’s theory was developed from existing tools. Pain-related indicators were clustered into nonobservable/subjective (patients’ self-reports of pain) and observable/objective (physiological and behavioral) categories.• Results A total of 183 pain episodes in 52 patients who received mechanical ventilation were analyzed. Observable indicators were recorded 97% of the time. Patients’ self-reports of pain were recorded only 29% of the time, a practice contradictory to recommendations for pain assessment. Pharmacological interventions were used more often (89% of the time) than nonpharmacological interventions (<25%) for managing pain. Almost 40% of the time, pain was not reassessed after an intervention. For reassessments, observable indicators were recorded 66% of the time; patients self-reports were recorded only 8% of the time.• Conclusions Pain documentation in medical files is incomplete or inadequate. The lack of a pain assessment tool may contribute to this situation. Research is still needed in the development of tools to enhance pain assessment in critically ill intubated patients.

scholarly journals Barriers perceived by nurses in the optimal treatment of postoperative pain

Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 239-246 ◽  
Author(s):  
Wioletta Medrzycka-Dabrowka ◽  
Sebastian Dąbrowski ◽  
Aleksandra Gutysz-Wojnicka ◽  
Aleksandra Gawroska-Krzemińska ◽  
Dorota Ozga
Keyword(s):  
Pain Management ◽  
Elderly Patients ◽  
Pain Assessment ◽  
Management Practices ◽  
National Level ◽  
University Hospital ◽  
Municipal Hospital ◽  
Post Operative Pain ◽  
Polish Version ◽  
The University

AbstractIt is currently estimated that the lack of adequate pain management affects 80% of the global population and the phenomenon poses a serious problem in more than 150 countries. On a national level, the greatest burden of inadequate treatment is borne, among others, by elderly patients. The purpose of the paper was to compare the prevalence of barriers to optimum post-operative pain management in elderly patients, observed by nurses in a clinical, provincial and municipal hospital in Poland. The research project was a multi-center one and took over a year. The study was questionnaire-based. It used the Polish version of the Nurses’ Perceived Obstacles to Pain Assessment and Management Practices questionnaire. The study included a total of 1602 nurses working at a clinical, provincial and municipal hospital.In the university hospital, difficulties in pain assessment related to the healthcare system occurred statistically significantly more often.

scholarly journals Improving Quality of Care via Effective Pain Management

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 895-895
Author(s):  
Jennifer Rose
Keyword(s):  
Older Adults ◽  
Pain Management ◽  
Pain Assessment ◽  
Nurse Managers ◽  
Assessment Tool ◽  
Emotional Reaction ◽  
Improvement Project ◽  
Pain Experience ◽  
Care Plans ◽  
Post Test

Abstract Pain is neither a vital sign nor a normal part of aging. Yet, older adults frequently experience pain chronically or from an acute event. Pain was identified as a gap per the Centers for Medicare & Medicaid Services Quality Measures report (2019). The purpose of this quality improvement project was to improve the assessment of pain at a skilled nursing facility (SNF) by using a standardized tool. The Comprehensive Pain Assessment Tool for the Cognitively Intact evaluates the complex sensation and emotional reaction of the pain experience. Nurse managers (N=7) received 1:1 education on pain, pain assessment, use of the pain assessment tool, and took a post-test. Chart audits were conducted to identify tool use and evaluate the patient response. Additional data were collected from nurse managers via a questionnaire. All nurse managers received education and completed the post-test. Pain assessments and care plans were completed for 100% of the SNF residents in the cohort (N=22). Follow-up assessments were completed on only 75% of the cohort. Of the cohort, 95% demonstrated improved physical ability and functioning in activities of daily living as their pain experience improved. Only 4.5% of the cohort participated in the anticipated level of minutes of therapy as a result of facility infection control limitations due to the COVID-19 pandemic. This project demonstrated improved pain management through use of a tool to comprehensively assess pain. An organizational policy to comprehensively assess pain at this SNF could promote a higher level of independence and functioning for older adults.

scholarly journals Pain Assessment in a Geriatric Psychiatry Program

2007 ◽  
Vol 12 (4) ◽  
pp. 273-280 ◽  
Author(s):  
Paul Stolee ◽  
Loretta M Hillier ◽  
Jacquelin Esbaugh ◽  
Nancy Bol ◽  
Laurie McKellar ◽  
...  
Keyword(s):  
Health Care ◽  
Pain Management ◽  
Pain Assessment ◽  
Health Care Professionals ◽  
Management Practice ◽  
Group Discussion ◽  
Geriatric Psychiatry ◽  
Assessment Tools ◽  
Pain Symptoms ◽  
Consistent Approach

BACKGROUND: The assessment of pain in older persons with psychiatric illness is particularly challenging for health care professionals. There are few well-tested pain assessment tools for this population.OBJECTIVES: A study was conducted to explore pain assessment and management issues in geriatric psychiatry.METHODS: Seventy-four staff members of a geriatric psychiatry service at Regional Mental Health Care London, St Joseph’s Health Care London, London, Ontario completed a survey to assess current pain assessment and management practice for geriatric psychiatry patients, and to identify indicators used to assess pain in this population. The results of the survey were later shared with members of the program’s pain management team in a focus group discussion to explore opportunities on how to transfer these findings into clinical practice.RESULTS: The majority of survey respondents (91.8%) agreed that pain assessment and management could be improved for patients; only 14.9% reported that there was a consistent approach to pain management. Misconceptions and attitudes about pain, lack of easily administered pain tools, inconsistent monitoring of pain, and lack of documentation of pain symptoms and indicators were identified as significant barriers to optimal pain management for their patients. A number of behaviours indicative of pain were identified but emphasis was placed on recognition of changes from usual behaviour.CONCLUSIONS: The findings of the present study highlight the need for a comprehensive, practical and consistent approach to pain assessment and management, and provide insight into the critical components, including behavioural indicators, that could be incorporated into a pain protocol to be used with this population.

CRIES: A Neonatal Postoperative Pain Measurement Score

2018 ◽  
pp. 263-267
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Pain Assessment ◽  
Reliable Method ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Neonatal Pain ◽  
Reliable Assessment ◽  
Assessment And Treatment ◽  
Neonatal Population

This case focuses on neonatal pain management by asking the question: Is the CRIES score a valid and reliable method for assessing neonatal postoperative pain? Regular pain assessment and treatment in the neonatal population are important postoperatively. The CRIES scale was designed to measure pain in the neonatal population, and this study demonstrated CRIES to be a valid and reliable assessment tool for identifying postsurgical pain in neonates. Multiple pain assessment tools, including CRIES, are available for use in neonatal patients and in patient populations who are otherwise unable to verbalize discomfort.

The Role of the CNA Pain Assessment Tool (CPAT) in the Pain Management of Nursing Home Residents with Dementia

2012 ◽  
Vol 33 (6) ◽  
pp. 430-438 ◽  
Author(s):  
Frank A. Cervo ◽  
Patricia Bruckenthal ◽  
Suzanne Fields ◽  
Lory E. Bright-Long ◽  
John J. Chen ◽  
...  
Keyword(s):  
Nursing Home ◽  
Pain Management ◽  
Pain Assessment ◽  
Assessment Tool ◽  
Nursing Home Residents

scholarly journals FEASIBILITY STUDY OF A NOVEL PAIN ASSESSMENT TOOL FOR IMPROVING PREHOSPITAL PAIN MANAGEMENT

2015 ◽  
Vol 32 (6) ◽  
pp. e12.2-e12
Author(s):  
Mohammad Iqbal ◽  
P Anne Spaight ◽  
Ros Kane ◽  
Zahid Asghar ◽  
A Niroshan Siriwardena
Keyword(s):  
Pain Management ◽  
Feasibility Study ◽  
Pain Assessment ◽  
Assessment Tool

P-385: Implementation of pain assessment tool changes nurses attitudes towards pain management in nursing homes

2015 ◽  
Vol 6 ◽  
pp. S135
Author(s):  
U. Stering ◽  
M. Schreier ◽  
S. Pitzer ◽  
B. Iglseder ◽  
J. Osterbrink
Keyword(s):  
Pain Management ◽  
Nursing Homes ◽  
Pain Assessment ◽  
Assessment Tool

Pain assessment, documentation, and management in a university hospital

2013 ◽  
Vol 4 (4) ◽  
pp. 256-257
Author(s):  
S. Zoёga ◽  
T. Aspelund ◽  
G. Sigurdsson ◽  
S.E. Ward ◽  
H. Sveinsdóttir ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Management Practices ◽  
University Hospital ◽  
Medical Patients ◽  
Cross Sectional ◽  
Adequate Treatment ◽  
Pain Management Index ◽  
Pain Medications ◽  
Pain Prevalence

AbstractAimsTo determine if pain is assessed, documented, and treated in a university hospital according to recommended practice.MethodsA cross-sectional descriptive study, conducted in 23 medical and surgical wards in a university hospital. Participants were patients hospitalized for at least 24hours, ≥18 years of age, and able to participate. Data were collected from patients with a questionnaire (APS-POQ-R), from their medical records, and from Therapy®, the hospital medication system.ResultsThe response rate was 73%. Participants (N =308) mean age was 67.5 years (SD = 17.4), 50.5% were women. Pain prevalence in the past 24 h was 83.1% and severe pain was experienced by 34.5%. Descriptions of pain were documented for 60.7%. Standardized methods of assessment were used in 11.6% of patients, other forms of documentation included descriptions as “no pain-complaints”, and “patient received 2 Panodil”. The majority of patients (66.8%) were prescribed pain medications and 34.0% of patients used non-pharmacological methods to treat their pain. The pain management index (PMI = prescribed pain medication – worst pain severity) was negative for 38.6% indicating insufficient treatment. The PMI was more favorable in surgical compared to medical patients, x2(6, N = 306) = 17.81, p = 0.007.ConclusionsPain was both prevalent and severe. Although some form of documentation of pain was recorded for the majority of patients, pain was rarely assessed with standardized methods. Many patients did not receive adequate treatment. There is a need to improve the pain management practices in the hospital, with an initial emphasis on pain assessment.

Factors influencing the control of post-operative pain in older people

2005 ◽  
Vol 15 (2) ◽  
pp. 149-156 ◽  
Author(s):  
Donna N Brown ◽  
Brendan G McCormack ◽  
Helen McGarvey
Keyword(s):  
Pain Management ◽  
Older People ◽  
Pain Assessment ◽  
Management Practices ◽  
Ethnographic Study ◽  
Post Operative Pain ◽  
Multidisciplinary Working ◽  
Key Issues ◽  
Care Culture ◽  
Knowledge Strategies

The purpose of this review is to discuss how healthcare professionals, and particularly nursing practice, impact upon pain management with older people (65 years and over), following surgery. The review commences with an introduction presenting why this is an important area to consider. Current available literature and findings from an ethnographic study which was designed to examine peri-operative pain-management practices with older people will then be discussed to highlight the key issues of pain assessment and management. Three overarching themes; (1) pain assessment (2) knowledge/strategies to cope with pain and (3) organization of care (culture and context), will guide the discussion. It is suggested that comprehensive pain assessment, proficient communication and multidisciplinary working, are essential to improve pain-management practices. The paper demonstrates some of the multiple and complex factors that affect the older person's pain experience and identifies possible developmental work in this field.

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