REFERENCES

Pain management in the perioperative setting

V I C T O R I A A V E R Y
O C T O B E R 2 0 , 2 0 1 3

SYTEMIC ANALGESICS

NSAIDS Opiods Fentanly

Effects of inadequate pain control

The most common reason for an unplanned admission to the hospital following ambulatory surgery, is inadequate pain control. The under treatment of postoperative pain can lead to a variety of issues including, respiratory and thromboembolic complications, increased length of hospital stay, impaired healing, and development of chronic pain. Approximately 70% of patients who undergo surgery believe that their pain is not being adequately controlled. Poorly managed pain can also damage a patients trust in their providers thus making them more anxious and less likely to heal appropriately. The goal of appropriate and successful post operative pain management is to improve the comfort and satisfaction of the patient, to facilitate the patients recovery and return to functional capabilities, reduce morbidity, and promote rapid discharge from the hospital.

PCA pumps

REGIONAL ANALGESICS

Local anesthetic agents Epidural analgesia Nerve blocks

Pain assessment
Successful assessment of pain is crucial to effective management. Pain is a subjective sensation and each patient experiences pain differently. This can make obtaining an accurate understanding of a patients level of pain challenging. A systematic evaluation, measurement, treatment, and re-evaluation can facilitate the management of pain by the health care team. The first step in proper assessment is to identify the proper scale to use when asking the patient about his or her pain. There are many different options available.

Role of the RN in pain management

According to the MA Board of Nursing the nurses primary commitment is to the health, welfare, comfort and safety of the patient. It is your role as a nurse to be an advocate for the patient. This means understanding pain and the appropriate management of pain. It is important to recognize some myths about pain. The following are common yet INCORRECT assumptions about pain: 1. Too much pain medication too frequently constitutes substance abuse, causes addiction, will result in respiratory depression or will hasten death; 2. Pain should be treated, not prevented; 3. People in pain always report their pain to their health care provider; 4. People in pain demonstrate or show that they have pain - pain can be seen in the patients behavior; 5. The level of pain is often exaggerated by the patient; 6. Generally a patient cannot be relieved of all pain; 7. Some pain is good so that the patients symptoms are not masked;

Examples of Pain Scales

My Unit 2 Project is an informational flyer that would be hung in the hospital. It is intended to further educate or remind registered nurses about the importance of pain control in the perioperative patient. Flyers such as this are common in the health care setting. It could be hung within the nurses station, in a break room, in a staff bathroom, or on an educational wall that is commonly found on floors in the hospital. Because this information is being directed at registered nurses the terminology is medically accurate. Nurses who work in the preoperative, operative, and postoperative areas of the hospital are familiar with much of the information and topics covered on the flyer. The importance of posting information such as this is related to the fact that nurses are expected to know an almost overwhelming amount of information at all times. They must know current practice and medications in order to treat all types of patients. In order to keep this information fresh in their minds, nurses are frequently re-learning and reminding themselves and each other of what they need to know. The flyer is bright and will be able to catch the eye of busy nurses as they go in and out of whatever area it is posted in. It is also broken down into sections for quick reference. Nurses are provided with a succinct summary of the important information. It is a great way to get nurses thinking about pain management without infringing on their practice. Nurses are very independent and self-driven in my experience. Using passive methods of sharing information often works because they are seeking out and applying information independently. The writing is clear and easy to understand and the piece is able to catch ones attention without becoming overwhelming. I would consider using this piece in a portfolio. I am proud of it and believe that it accurately reflects the goals of the assignment. I believe that this flyer could easily be found in a real-world setting and that it is appropriate for the assignment.

REFERENCES
Post-operative pain management. In: Bader P, Echtle D, Fonteyne V, De Meerleer G, Papaioannou EG, Vranken JH. Guidelines on pain management. Arnhem, The Netherlands: European Association of Urology (EAU); 2009 Mar. p. 62-82. Wood, S. (2008, September 18). Assessment of pain. Retrieved from http://www.nursingtimes.net/nursingpractice/clinical-zones/pain-management/assessment-of-pain/1861174.article