Ebp Pain Management

pain is the usual cause for persons to look for treatment. Inadequate pain management can cause delay in healing process. It can also leads to prolonged hospital stay. The acute pain management theory describe how nurse can manage pain with minimal effects from the pharmacological interventions and use of alternative methods of pain management (Good &Moore, 1996) The main factors are in the management of pain are Pharmacological, non-pharmacological, patient participation, education and different interventions. Effective pain management involves the application of non-pharmacological interventions and usage of pain medications. (McEwen & Willis, 2014). The pain management theory deals with management of pain in daily basis. It offers the knowledge about alternate methods in pain

The medical personnel should know the patient in depth, care about their differences, preferences and values. The priority of concern should be the patient's comfortability. The nurse aims to relive the patient of pain, ensure continuity of care and involvement in decision making. Measures of quality of care include structure and process about patient needs. There is need to implement change in methods and systems aiming at improving quality.

Appropriate assessment and management of pain should be paramount to nurses working in the elderly care sector.

First pain is an everyday experiences that is expressed through the use of language and is then legitimized (Waddie, 1996). If a patient as a history of depression or chronic pain they have pain every day and the concept is used to help explain their pain. As nurse we use the concept of pain to find a base line of the pain and to assess new pain. In surgical patients they may have multiple types of pain from the incision, emotional, and history. The concept educates the nurse of the different form that pain can present itself. Pain can also guide how we treat the patient. Emotional pain would not be treated with the “so know pain pills”, but with talking or listening to patient. Concept of pain also address the different form of patient and how the nurse and patient response to it. If a patient is having somatic pain from an incision the nurse could react by applying heat or ice. Pain is what the patient says it is.

JCAHO (2011) also stated that patients and their families needed to be educated about pain and how the patients’ pain is going to be managed. Every patient perceives and exhibits pain in a different manner and if nurses do not assess the patient thoroughly they can miss it. For instance, Engebretson et al. (2006) acknowledged that, patients manifest pain in different ways and this resulted in nurses performing an inadequate assessment of their patients’ pain. Also, Engebretson et al. recognized that patients often conceal their pain because they do not want to be viewed by staff as complainers or addicts, and if patients decide to speak up the nurses frequently view their patients’ statements from their own cultural, moral and ethical belief system and not their patients which leaves the patients’ pain untreated.

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.

Pain is one of the most common reasons people consult a physician, yet it is frequently inappropriately treated [St Stauver JL, 2013]. To deal with this dilemma, nurse practitioners can play an important role on the pain care team, particularly as primary care clinicians spend less time with patients and are increasingly reluctant to provide care for pain patients. As frontline providers, they can take the time to perform a thorough patient assessment and physical examination and follow through with pain treatment, while also playing an essential role in patient education and assessing and monitoring the patient’s opioid risk. Their primary goal is to develop a therapeutic relationship with patients, providing the time and space for patients to tell their pain story [Hughes, 2013], which they then can communicate to the rest of the team and which forms the basis for all subsequent decisions about treatment.

According to The World Health Organisation (1999), defined pain as an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain is traditionally described as acute or chronic pain. The prevalence of chronic pain (CP) is higher than of acute of pain, as it affects 7.8 million people of all ages in the UK (Chronic Pain Policy Coalition., 2006). The current leading cause of mortality that is accounting for 60% of all deaths is due to chronic diseases and is also a problem as causes an increasing burden on the health care service (World Health Organisation., 2007). CP can affect a person’s quality of life if managed poorly, statistics shows that 25% of people lose their job and 22% leads to depression. (Chronic Pain Policy Coalition.,

This paper will examine the the nurses and pain assessment in the hospitalized patient. The paper will focus on pain and pain management and the need to assess pain. How much percentage of the population in the U.S. are experienced pain, and how much of the population abuse the pain medications. There are many barriers which hinder nurses from perform accurate pain assessment. These barriers are nurses experience, competence, perception and manipulation. Pain is subjective, but pain assessment tools and nurses’ perception may contraindicate with what the patients stated. Thus, the paper will try to find solution to accurate pain assessment during hospitalization, especially with abuse of opioid.

Assessing pain is a very important first step. Having the correct assessment techniques and tools is very important to diagnosing and treating the pain. Acute pain is typically a symptom of something else, so correct assessment will lead the care provider to the underlying issue, D’Amico and Barbarito (2016) identify many tools used for the assessment of pain, discussed later in the paper. Treatment of acute pain should be handled differently than other types of pain due to acute pain being a short-term process of healing. The

Kolcaba explained three different views of comfort. First meaning, “as the state of having discomfort relieved”, secondly as the “state of ease and peaceful contentment”, third “as relief from discomfort” (Kolcaba, & Kolcaba, 1991). These states of comfort are continuous, interdependent and can overlap (Kolcaba, 1991). A goal of nursing practice, as contained in statements of standards for care, has been generally to help the patient be comfortable or be in a state of comfort (Kolcaba, & Kolcaba, 1991). Patients require comfort care pre-, intra-, and post-operatively. For the surgical patient, comfort care is initiated from admission until discharge. The purpose of this paper is to provide a concept analysis of comfort care with the goal of better understanding of its key attributes in order to clarify its use in nursing practice, theory and research. The defining attributes will be discussed, model cases, and additional cases will be reflected. Antecedents and consequences will also be identified. Finally, the last section of the paper will identify some of the ways that the defining attributes can be measured.

Lewis, S., Dirksen, S., Heitkemper, M., Bucher, L. (2014). Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 9th Edition. [VitalSource Bookshelf Online]. Retrieved from https://pageburstls.elsevier.com/#/books/9780323086783/pages 1525-1527

EBP is a good source to have at a healthcare facility it clearly analyzes the proper way the organization should be facilitating. Proper protocol for faculty and staff and educational training for elimination of problems that may occur in the future. As was stated previously in this article lack of knowledge is not a good thing to have, but knowing the aspects of what could occur and stopping it before it because a nuisance can elevate problems that may arise in the near

Managing pain – To determine if Mr Dwight’s pain is well managed, 0-10 numerical pain rating scale with measure of patient pain satisfaction is advised (Phillips, Gift, Gelot, Duong, & Tapp, 2013, p.684). If Mr Dwight reported a lower numerical pain score after implementing interventions for his pain and reports being satisfied then that would support that the goal of managing his pain is achieved.

Applying Theory to a Practice Problem: Part 2: Application of Middle-Range Theory to Problem The very common healthcare problem of human being is known as pain the noxious feeling of an individual expressed as unpleasant sensory and emotional experience in relation to actual or potential tissue damage (Merskey, 1986). Pain is considered as fifth vital signs and it is subjective in nature classified as acute and chronic pain in order to manage properly. Nursing perceptive points of view pain is under- estimated and mismanaged at some extent. The adoption of middle range theory related to comfort and the interaction of nursing practices are going to be discussed by the writer.