Current Practice Protocol For Pain Reassessment And Documentation

“ The ADKAR model of change includes Awareness of the need for change, the Desire to support the change campaign, Knowledge of how to make this successful, the Ability to implement new strategies, Reinforcement of change implementation, and periodic re-evaluation (Hait,2006). These four elements promote evidenced- based practice change and the commitment from nurses to participate in professional activities.”(Robert & Pape, 2011, p. 43) A APRN’s we will have to be agents of change to provide the best care for our patients. When we identify a issue or concern we must have the ability to address it

Implementing a change project is a challenging step of the Capstone Change Project. This paper focuses on steps that must be taken to implement a change, strategies to ensure the success, involved stakeholders and their roles, educational requirements, safety issues, ethical considerations, and external or internal regulations’ effects on the process. It also include the change theory, nursing theory, and evidence based practice influences on the implementation process.

Pain is a condition that is determined and described by the person reporting it. There are several components to pain including the emotional, psychological, and physical aspects. Many health professionals struggle to understand this phenomenon and thereby insert their own perspectives into the pain assessment of patient reporting pain. The Affordable Care Act (ACA) (2010), also titled the Patient Protection and Affordable Care Act H.R. 3590, was passed by Congress and signed into law on March 23, 2010 (U.S. Department of Health and Human Services (DHHS), 2013). Hospital value based purchasing programs (VBP) were developed to align patient quality care and outcomes to the support initiatives from the ACA. A component of the VBP includes patient satisfaction. Patient satisfaction is a self-reported response to questionnaire administered by a third party. Many hospitals utilize Press Ganey to administer the survey for the inpatient and outpatient patients. One component the survey includes patient’s self-reporting how well their pain was managed during their hospitalization. This measure of satisfaction can have an adverse effect on patient outcomes and increase opioid use in this setting. Patient satisfaction and pain management are both subjective however pain management while within scope of healthcare professionals should not be included in the patient satisfaction survey.

What additional assessment tools would you select that would be appropriate for Clint and why?

The Pain Assessment Survey was developed to assess whether registered nurses are using evidence-based standards to assess and manage pain for special populations. Descriptive statistics were used in this study. The sample group surveyed included registered nurses currently enrolled in an on-line Baccalaureate program. A quasi-non-experimental study was utilized to allow the collection of a large amount of data at one time, while allowing the researches to compare and contrast the use of evidence based practice standards when preventing medication errors. This study contained both dependent and independent variables. The independent variable present is the use of evidence-based practice standards in the assessment of pain in special populations. The dependent variable is the management of pain in special populations of different cultures and chronic pain syndromes. The researchers concluded that out of the 50 participants of the survey, the majority use the verbal pain scale. The researchers concluded that registered nurses are using evidence-based standards of practice when assessing pain in special populations such as those with different cultural backgrounds and those with chronic pain

As a first part of the holistic assessment process the nurse collected the subjective data, which are the data from Anne’s point of view during the interview (delaune).the nurse gathered information regarding present medical history, past medical history and activities of daily living. Anne mentioned that she was diagnosed with oesophageal cancer one year before. She also added that she was suffering from pain and swallowing difficulty for few days and that was the main reason for her admission in the hospital. On observation the nurse noticed that Anne is very anxious and fragile. The pain assessment carried out and Anne was scoring six on the pain chart .marmo Liza suggest that pain is an unfavourable experience and each persons perception

Two pt verifier name and dob confirmed. Pb states that the pain management doctor is requesting a recent MRI to continue treatment. Informed the pt that he request was sent to her provider for review and recommendation. We call her within the 72 hours with her provider's recommendations. Please advise!

As a nurse there are many variations of the pain assessment I could undertake with Mrs Jones. (Herr & Garand, 2011)

A classic definition of change is that of (Lippitt, 1973), who described change as any planned or unplanned alteration in status quo of an organism, situation, or process. Planned change is described as the deliberate, calculated and collaborative application of knowledge and skills by a leader to bring about improvements (Marquis & Huston, 2015). The NMC Code (NMC, 2015) states that nurses and midwives ‘deliver care based on the best available evidence or best practice ' this indicates the continual need to enhance practice through change. As well as the code of conduct

Herr, K., Titler, M., Fine, P. G., Sanders, S., Cavanaugh, J. E., Swegle, J., Forcucci, C. (2012) mentioned some of the challenges commonly faced regarding pain management, these include: misconceptions about pain, evaluating pain in those who have cognitive impairments, those with multiple co-morbidities, polypharmacy issues and those who are reluctant to take opioids analgesics. It has been noticed that the problem involves lack of application of Evidenced Based Practice (EBP) for pain by nurses and physicians. The reason for conducting this research is to report on the results of a Translating Research Into Practice (TRIP) intervention, that includes strategies designed to promote adoption of

In an article entitled Pain Assessment Using Self-reported, Nurse-reported, and Observational Pain Assessment Tools among Older Individuals with Cognitive Impairment

Once the main causes of arthritis are identified and therapy is initiated, a pain log or diary is an appropriate tool to assess the effectiveness of the treatment provided. The patients are normally encouraged to record their pain characteristics on a daily basis. This will allow the healthcare providers to evaluate the progression of the patients throughout the treatment. Regular pain reassessment is done by using the previously administered pain scales. This is a vital step to modify the treatment or therapy in order to assure an optimal and positive outcome (Cavalieri,

Develop an interdisciplinary work group. An inter- disciplinary approach—and “buy-in”—is essential to change an organization’s practice patterns. Invite mem- bers from all disciplines that have pain management in their practice responsibilities, including nursing, med- icine, pharmacy, as well as representatives from admin- istration. Invite those people who may be the most resistant to change. Consider also including patient and family representation whenever possible.

The nursing staff will have the most important role in this process change. The nurses are the ones who see the patients first. The nurses will need to be onboard and understand that this process change will help us give our patients the knowledge they need as well as increasing their satisfaction. Each nurse will be responsible for maintaining the educational materials while making sure the information is accessible to our patients. An important part of this process change is to make sure the staff is onboard and the patients are receiving the information. The nurses will be able to influence and hold each other accountable for this process change. The nursing staff has the best interest of the patients and want to provide the best care they can. The nurses have the power to either bring this project along or they can hinder this

establish a recommendation to redefine the role of the nurse and to examine the nursing education. Also, the Robert Wood Johnson Foundation (2003) encourage the Instituted for Healthcare Improvement to collaborated in the design of a plan to ameliorate the hospital environment.