The Pain Epidemiology Of Pain In Children

Pediatric pain management is measured subjectively because it is based off of what the patient says or how the nurse interprets the pain scale. Pain is rated using different scales, unfortunately these different scales could yield different results. Nurses are trained to use pediatric pain scales to analyze and treat pain but parents are not supplied with the tools to manage pain when the patient goes home. With 84% of all pediatric surgical procedures performed on an outpatient basis, the importance of teaching parents how to assess for and manage pain has become more important than ever (Rony, Fortier, Chorney, Perret, & Kain, 2010). According to Rony’s et al. (2010) study, it is apparent that pediatric pain is not being treated effectively. The study showed that 58.8% of children were receiving less than the daily recommended does prescribed by the pediatrician (p.1). Results of the study also showed that parents had false assessments on if their child was actually in pain. 36% of parents believed that if their child was in pain, they would cry out for the parent , 30% agreed that their child would always tell them if they are in pain, while 22% said that the child would report their pain immediately (Rony, Fortier, Chorney, Perret, & Kain, 2010, ). Children do not always verbalize when they are in pain. Sometimes the pain can be so intense that a child is unable to talk. If the child catches on to the parents negative perception of pain medications, the child may not

The pain that the infants experience has a significant and lasting impact. In addition to the acute pain and stress experienced while in the NICU, there are lasting effects of these procedures for the patients. According to Grunau, et al. (2013):

Children presenting to the emergency department are often subjected to painful and anxiety-producing procedures, both for diagnostic purposes and for treatment of symptoms. Historically, pediatric patients have not been afforded the same level of care as adults with regard to the management of procedural pain. Pain in the young child age group (1-7 years) has often been under-treated,

In this study the researchers tested the pain responses in newborns who are experiencing heel sticks. They split forty-eight newborns into four categories, each with a different type if milk odor origination. The four groups were: own mother’s breast milk odor, another mother’s breast milk odor, formula milk odor, and a control group (Nishitani, 2009). Different reactions were recorded in the duration of the heel sticks such as crying out, grimacing, and motor activities. Another

Children are taken to the emergency department for various reasons, but pain is one of the most common. Habich and Letizia state, “Despite the high frequency of pain, pediatric patients are often not appropriately assessed for pain.” Nurses and other medical personnel failing to properly assess the pain in the emergency department is a problem that needs to be fixed. To resolve this problem, Habich and Letizia decided to conduct an evidence based protocol to review what ways the program needed to review.

This year everyday Friday in Language I have been working on a project called the 20-Time. The 20- Time project is when we take twenty percent of our time to create a project for the greater good. This concept is being used throughout many schools in the country. Based off this concept many great successes have occurred. For example, Gmail and Google Maps were both created from the 20-Time. What I have been researching for the 20- Time Project is a disorder called Congenital Analgesia. Another name for it is called Congenital Insensitivity to Pain (CIP). CIP is a rare condition that inhibits the body’s ability to perceive physical pain. During this project I had many successes, a huge hurdle to overcome, and I learned many things. It is my goal to detail my personal reflections about working on the 20-Time project.

Statistics are showing that the pediatric population is at risk of insufficient pain management, with age-related issues that are having an effect on pain management that is in children. Children are regularly provided token or no analgesia for actions that would habitually be preserved hostilely in adults. With said, making sure that the pain management department is running effectively is very important. The importance of improving the care provided in America's pediatric division has encouraged the development and endorsement of an increasing portfolio performance measures especially in pain management (Bhargava, R., & Brown, L., 2011). It is important to understand that promoting a high performing health care system does require better measurement and the utilization of those measures to compensate proper care, improve health outcomes, and permit customers and purchaser to utilize the statistics to make suitable value-driven choices (Feinberg, 2002). Even though there has been quite a bit progress over the past decade in the parts of measure growth and commendation, there continues to be important breaches in both serious measurement areas - for instance competence and differences of care - and putting that info to use for performance-based imbursement, consumer support, and quality improvement. Saying all of this, this essay will analyze and critically discuss pain management in the pediatric department.

Policies and resources are important tools to use for guidance on developing a plan of care for pediatric pain management. Nurses must look at their hospital policies to determine the appropriate actions to take. The Doernbecher Children’s Hospital in Oregon developed a policy using a multi-modal approach for the staff to follow. A multi-modal approach is where pain management is provided before, during, and after all procedures that may cause pain and/or anxiety for the child (Oregon Health & Sciences University, 2012). Team huddles are used before procedures to discuss the appropriate pain management approach that will be used based on the child. The nurse’s report and assessment on the child’s past perceptions of pain, any current symptoms the child is facing, and cultural background are important for other members of the healthcare team to create a proper plan during huddle. If the child’s nurse feels that the child needs more pain interventions, the nurse may stop the procedure to provide the child with additional comfort measures (Oregon Health & Sciences University, 2012). The policy in place at Doernbecher Children’s Hospital is developed in order to provide the child with compassionate care while alleviating pain and anxiety that will decrease any physical or psychological effects caused by untreated pain. All hospitals must have a pain policy in place for guidance on how to provide quality care.

Since the early 1980s it was found that neonates have the ability to understand the pain and do respond to it. Neonates compared to children and adults are more sensitive to pain. Neonates admitted to neonatal intensive care unit daily are under painful care and treatment. Faced with the pain not only causes acute psychological symptoms, but can cause changes in structure and function of neonates brain. There is evidence that untreated severe pain and long recovery may prevent or delay the healing process and therefore increase the cost of health care. This study aimed to determine and evaluate implementation of neonatal management of pain in NICUs.

Newborn infants are routinely exposed to painful procedures, for example, injection, heel lancing, arterial stab, or circumcision (Heaton, Herd, & Fernando, 2007). Frequent pain is harmful to the neonates in the phase of physiological development (Thompson, 2005). In particular, infants are at high risks when responding to immediate pain, resulting in increased heart and respiratory rates, increased blood pressure, decreased oxygen saturation, and a release of adrenal stress hormones. In addition, since premature

The study conducted by Stanley and Pollard (2013) had two components. The first was to assess the amount knowledge concerning pediatric pain management of nurses then gauge their attitudes and level of self-efficacy concerning acute pediatric pain care. The second was an examination of the relationship between years of experience, amount of knowledge, attitude, and levels of self-efficacy. According to the authors, studies have previously indicated that care may be affected by the level of knowledge and attitude of the nurse, however no research existed between each component and self-efficacy. Stanley and Pollard predicted that a nurses job performance concerning adequate pain management of pediatric patients would be affected by the two components examined. (Review of literature ) They presented the problem by citing previously conducted peer-reviewed studies indicating that proper pain management of pediatric patients was lacking and which emphasized the importance of knowledge of the topic [cite]. Examples were given of barriers to proper pain management which included: ignoring patient self-report, lack of education about pain assessment, misunderstanding pharmacological effect on the respiratory system, lack of a universally applied pain management system, work security concerns, perceived inferiority, and time constraints. ( Stanley et al., 2013)

Pain management in the neonatal intensive care unit (NICU) has always been a controversial topic. There are many misconceptions regarding if neonates feel pain. The importance of pain in newborns was first recognized in the 1980s. In the past, it was thought that they could not feel pain due to the immaturity of their peripheral and central nervous system. This was proven to be untrue and studies show that infants do indeed feel pain. Even with this being proven, neonates are often under treated or not fully recognized as being in pain. There seem to be gaps in-between clinical practice and actual knowledge regarding pain management. Many health care workers are unaware of how to most effectively manage pain in neonates and this is a major

My profound passion for chronic pain psychology led me to your researches about it particularly, Pediatric fear-avoidance model of chronic pain, Anxiety Disorders: Panic Disorder and Agoraphobia, Re-Thinking the Fear Avoidance Model: Toward a MultiDimensional Framework of Pain-Related Disability, besides, Pediatric fear-avoidance model of chronic pain: Foundation, application, and future directions. Also, your special essay “ how I work " inspired me concerns having balance in life. Hence, if time permits, I hope to have your advice regarding choosing chronic pain psychological treatment as the major of my master research.

In emergency rooms across the United States one of the most common complaints is pain. Recently, there have been reports on the news saying that doctors have a problem with prescribing too much pain medication. That may be true for adults but the same cannot be said for pediatric patients. A study of 24,707 Emergency Department (ED) visits reported that one 44% of pediatric patients have very little pain control in spite of pain documentation (Ramira, Instone, & Clark, 2016, p. 39). Sometimes it seems as though health care professionals take the pain of an adult more serious than a child’s. In the article, Pediatric Pain Management: An Evidence-Based Approach conducted by Maria Ramira, APRN, Susan Instone, APRN, and Mary Clark, PhD RN seeks to address this issue and introducing methods that might improve pediatric pain management.

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1979). Pain is actually the culprit behind warranting a visit to a physician office for many people (Besson, 1999). Notoriously unpleasant, pain could also pose a threat as both a psychological and economic burden (Phillips, 2006). Sometimes pain does happen without any damage of tissue or any likely diseased state. The reasons for such pain are poorly understood and the term used to describe such type of pain is “psychogenic pain”. Also, the loss of productivity and daily activity due to pain is also significant. Pain engulfs a trillion dollars of GDP for lost work time and disability payments (Melnikova, 2010). Untreated pain not only impacts a person suffering from pain but also impacts their whole family. A person’s quality of life is negatively impacted by pain and it diminishes their ability to concentrate, work, exercise, socialize, perform daily routines, and sleep. All of these negative impacts ultimately lead to much more severe behavioral effects such as depression, aggression, mood alterations, isolation, and loss of self-esteem, which pose a great threat to human society.