Pain management and assessment standards
At some point in life, individuals are subjected to pain. There are two main types of pain that are chronic and acute pain. Acute pain is subject to subsiding as ones regain a healthy body state. However, chronic pain is persistent and therefore has been classified nonmalignant and cancer-related pain (Hall & Gregory, 2016). These types include the low back pain and peripheral neuropathy. Controlling the pain in a human body is an essential requirement since one is able to perform well when he or she is relieved of pain. Inadequately managed pain has the effect of leading to adverse psychological and physical outcomes for an individual and the involved family as well.Consequently, unrelieved pain has the possibility of activating the pituitary-adrenal axis. The results are adverse since the immune systems are suppressed leading to postsurgical infection and poor healing of wounds.
Some of the common psychological responses include depression and anxiety. According to a research conducted by Kirksey, Meglory & Sefcik, failure to escape from pain might lead into sense hopelessness and helplessness to the affected patient; the outcome is unfavorable since the patient can be predisposed into a more chronic condition (depression) (Kirksey, Meglory & Sefcik, 2015). A great number of patients experiencing inadequate pain management tend not to seek medical care related to other help problems. Poor pain management can lead clinicians into complications with the legal authorities. There are current standards set by the Joint Commission, the association necessitated pain be promptly and addressed and managed (Kirksey, Meglory & Sefcik, 2015).
Dangerous outcomes of unrelieved pain
Pain is the main cause of stress: pain cause the endocrine system to have reactions which make it release excess hormones, this damages the fat, proteins, carbohydrates and poor use of glucose and other harmful effects (Hall & Gregory, 2016). When the above processes occur, the reaction might combine with inflammatory processes which result in weight loss, fever, shock, increased respiratory, and death. The recovery period of a patient is affected due to prolonged stress response. Other effects include chronic pain in the future, blood pressure, oxygen demand, increased heart rate, and cardiac workload (Hall & Gregory, 2016).
To provide proper pain management assessment is necessary. Anderson report that lack of pain assessment builds a barrier to proper pain control of pain. Regardless of the availability of many recommendations about pain assessment, some do not apply to acute assessments. Nurses that work on the hospitalized patient suffering from acute pain are advised to select appropriate assessment elements depending on the present medical circumstances. Pain assessment should be practiced using the standard format; mostly every two hours. The parameters for assessing pain must be in compliance with the respective hospital or unit procedures and policies. Pain reassessment is advised that the patient needs are met. The above must be done after every intervention to make an evaluation of the effect and determine whether there is a need for modification. The reassessment must also follow a specified time frame also directed by the hospital’s policy and procedures (Hall & Gregory, 2016). The nurse is entitled to identify the attitudes of the patient, beliefs, knowledge level, as well as previous experiences with pain. The family expectations for regarding control of pain uncover other issues that must be addressed before the surgery.
Patient satisfaction with pain management is not a better way of determining the quality for pain control. The fact that it is difficult to interpret the patient satisfaction findings makes it not a favorable form of patient satisfaction indicator. Commercial patient satisfaction surveys serve as the best ways to monitor patients’ satisfaction with care. Other forms of assessing patient satisfaction include the use of generic health statue surveys, the use of Medical Outcomes Study Short Form-36. The surveys are characterized by questions concerning pain experienced by the participants. Once a review of conduct concerning the pain experienced can be used to measure the quality of pain care.
Some of the pain assessment tools include the visual analog scale and the numeric rating scale (NRS). Other simpler tools are verbal rating scale which helps classify pain in mild, moderate and severe levels. Patients suffering from advanced dementia necessitate interactive observation so as to determine the presence of pain in the patient’s body. Other tools such as PAIN-AD are also used. The joint commission also necessitates the use of pain standard tools. The commission requires hospitals to make use of similar assessment tools in all departments. The prescribed tools provided by the commission are the Wong-Baker FACES scale, NRS and the verbal descriptor scale. The tool to use has to be an agreement amongst the patient and the healthcare worker. The action makes it possible for the patient to familiarize with the assessment tool. There is also a need for the nurse to take note of the patient’s age, cognitive status, and preference before selecting a scale.
Pain reassessment and management
The need for pain reassessment after the patient has undergone an assessment is essential. The main reasons that demand pain reassessment after an intervention cannot be underrated. According to the Joint Commission proposed pain assessment ways discussed above, it is possible to note the emphasis lay concerning the need to recognize pain management. The commission argues that individuals or institutions must not ascertain pain management as the elimination of pain and discomfort; instead, it means aiding and reducing pain management. Wadensten, Fröjd, Swenne, Gordh, & Gunningberg (2011) studied the effectiveness of pain programs in various clinics. Regardless of the nursing interventions, a huge number of patients experience pain that makes them dissatisfied with the manner management programs were managed. Apart from pain intervention and reassessment, there is a need for effective communication between the nurses and the patients. When communication is present, patients tend to develop satisfaction with the pain management.
The intervention aimed at reassessing the state of a patient’s pain after an assessment is inevitable. Nurses must also document their reassessment details in the Electronic Medical System (EMS) referred to an EPIC (Schroeder et al., 2016). By making use of this process, the value of document rate for the nurses should rise from the baseline to 75%. There is a need for nurses to heed in pain reassessment since patients’ pain remains the vital component of their health and satisfaction. Through good use of scheduled pain reassessment time frames, the pain of patients can be appropriately managed and addressed. When pain is properly managed, there is a possibility of the rise of patent satisfaction. The results are higher marks for the designated hospital as of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and in turn demand for high reimbursement. Also, reassessment makes the length of stay for patients reduce. Patients suffering from pain need to be treated with care since a large number tend to suffer from mobility, which calls for complication. Increased lack of concentration from the nurses makes a recovery inefficient and in the long-term effect is prolonged stay and complications. Chronic issues are also present in patients who do not have their pain reassessed; the effect can be detrimental to the patients’ worth of existence (Lin et al., 2014). Pain reconsideration remains a vital aspect of pain administration. Patients must be considered in every aspect of the clinical healthcare; a patient remains a valuable aspect of the nursing practice. With the appropriate pain reassessment, the quality of healthcare will be improved. When the process is put in writing a chance for improvement is created. Patients are obliged to ensure that the pain of each patient is reassessed after a specified time and with specialized interventions.
To sum up, a discussion of the Joint Commission management standards in regard to pain management and reassessment makes it possible for nurses and other healthcare providers to provide reliable services to patients. With the various tools and highlighted above enable the health workers to discern concrete and reliable information concerning the quality of patient satisfaction. The need to reassess the patients’ condition s makes avails room for making decisions regarding the perception of the patient about the quality of services. Patients feel satisfied when nurses or other healthcare providers engage them in the sharing of the information process. Use of the suggested tools also is a valuable approach towards attending the patients. Hospitals need to have a consistent way of assessing pain among its patients. The above is achieving through the employment of the Joint Commission suggested tools.
Lin, R. J., Reid, M. C., Chused, A. E., & Evans, A. T. (2014). Quality Assessment of Acute Inpatient Pain Management in an Academic Health Center. American Journal of Hospice and Palliative Medicine, 33(1), 16-19. doi:10.1177/1049909114546545
Kirksey, K. M., Mcglory, G., & Sefcik, E. F. (2015). Pain Assessment and Management in Critically Ill Older Adults. Critical Care Nursing Quarterly, 38(3), 237-244. doi:10.1097/cnq.0000000000000071
Wadensten, B., Fröjd, C., Swenne, C. L., Gordh, T., & Gunningberg, L. (2011). Why is the pain still not being assessed adequately? Results of a pain prevalence study in a university hospital in Sweden. Journal of Clinical Nursing, 20(5-6), 624-634. doi:10.1111/j.1365-2702.2010.03482.x
Schroeder, D. L., Hoffman, L. A., Fioravanti, M., Medley, D. P., Zullo, T. G., & Tuite, P. K. (2016). Enhancing Nursesʼ Pain Assessment to Improve Patient Satisfaction. Orthopaedic N
Hall, G., & Gregory, J. (2016). The assessment and management of pain in an orthopedic out-patient setting: A case study. International Journal of Orthopaedic and Trauma Nursing, 22, 24-28. doi:10.1016/j.ijotn.2015.10.001 ursing, 35(2), 108-117. doi:10.1097/nor.0000000000000226