Pain Management For Patients With Acute Or Chronic Illnesses And Assessment Of Pain

Many individuals do not like the idea of change, but as health care professionals we know that change is a part of our profession. Evidence-based practice is present and the future of health care practice and needs to be fully supported by every health care team member. The gap between understanding EBP and applying it needs to be a thing of the

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 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

The introduction of EBP onto healthcare improvement scene constituted a major paradigm shift. This shift was apparent in the ways nurses began to think about research results, the way nurses framed the context for improvement and the way nurses employed change to transform.

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.

To start my plan for implementation, I will first talk to my director of nursing, manager, and nurse educator for approval. I plan to implement increase evidence based practice use in my department (cardiac unit). I will obtain information from our quality assurance nurse to evaluate how our core measures like AMI, chf, and stroke bundle is being consistently followed by the nurses in my department. I plan to empower staff nurses to use EBP. I will schedule workshops for nurses interested in learning more about research and EBP, increase access to library resources and EBP information, interactive EBP skills and rounds, development of EBP mentors and champions. The change should be an ongoing support from the leaders and organization to

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.

Nursing assessment is a substantial way of gathering physiological, psychological, spiritual, and emotional condition of the patient. It creates a whole picture of an individual and assist the health care providers to formulate a diagnosis. Assessing the comfort of the patient is equally important as taking the blood pressure or temperature. Pain is the fifth (5th) vital sign that is subjective in nature when performing an assessment of a patient. Various studies were conducted in finding the most appropriate evidence-based nursing practice in assessing and managing the pain of a cognitively impaired patient, whether it is acute or chronic or the underlying cause is cancer or post-operative incision. As emphasized by Song, Eaton, Gordon, Hoyle, and Doorenbos (2015), it is vital to ensure that “pain management is based on the best evidence” (p. 456). Perhaps knowing the causes of inability to assess and manage the pain in a cognitively impaired patient would give a clearer understanding of the practice.

Nurses are cheered to integrate and apply EBP as part of their daily practice. EBP is “knowing that what we do is the best practice” (AMSN, 2014). EBP is very important in health care system and can dramatically change quality care and clinical outcomes. According from the Iowa/Titler Model from AMSN (2014), the EBP process have five steps:

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

numeric values from 0 through 10 which is then added up to determine patient’s severity of pain. Zero means no pain and ten mean severe pain. (Warden, V, Hurley AC, Volicer, V. (2003) Another Pain Assessment tool used is the Numeric Rating Scale (NRS). With the NRS pain scale, patients are asked to rate their pain level from 0 to 10. Zero means no pain, ten means worst pain. The nurse must ensure the patient is comfortable, and is encourage to ask question before the assessment begins. The patient must be allowed to describe their pain without any interruptions or judgement. If an interpreter is needed one must be provided. Family memebers and caregivers can be incorporated into the assessment to better understand the patient’s pain when they are non

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

‘Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage’ (International association for the study of pain 2014). Pain can be made up of complex and subjective experiences. The experience of pain is highly personal and private, and can not be directly observed or measured from one person to the next (Mac Lellan 2006). According to the agency for health care policy and research 1992, an individuals self-report of pain is the most reliable indicator of its presence. This is also supported by Mc Caffery’s definition in 1972, when he said ‘Pain is whatever the experiencing patient says it is, existing whenever he says it does’.