Introduction The topic of this essay is pain assessment in advanced dementia scale (PAINAD) (Appendix 1) (Warden, hurley and Volicer 2003). This PAINAD was discover during my field visit in community hospital which is the Assisi hospice. Assisi hospice use this as a clinical guide line in assessing pain for demented patient, this drive me to know more about assessing pain for this special group of demented patient. In Tan Tock Seng hospital, both general ward and geriatric ward are not using this pain assessment in advanced dementia scale for assessing pain for demented patient. In Tan Tock Seng hospital, both general ward and geriatric ward nurses are using Wong baker pain assessment scale for those patient unable to describe or verbalize …show more content…
There are symbolic of pain: breathing independent of vocalization, negative vocalization, facial expression, body language and lastly is consolability. For using this pain assessment tools, nurse has to observed the advanced demented patient both at rest and during activity with or with treatment. For each of the five components select the score (0,1, 2) that demonstrated on the patient’s behaviour. Added the score in each component then giving a total maximum score of 10. The score range from 0 to 10 indicated higher number showed more severe pain. This scoring allow nurse to monitor the pain by giving the pain medication according to the pain level as well as able to monitor whether patient response to the pain treatments over …show more content…
There is no conflict of interest regarding this pain assessment tools. For meaningfulness, implementing PAIND improved quality of life of demented patient. This was showed that pain was addressed in a manner that medication given able to reduce the distress , agitation behaviour. Implementing PAIND does not bring any harm and potential risk to patient. Next, For the effectiveness, it is better than Wong baker scale which was used in Tan Tock seng Seng because that does not specific to address pain in demented patient. Conclusion: Pain assessment is significant in nursing for everyday practice in the clinical area. The correct assessment tools able to evaluating the correct medication, treatment and elderly’s quality of life. Assessment in cognitive impair demented patient is challenges difficulty, nurses using a pain assessment scale in detecting pain and provide a comprehensive approach to solves the pain problem. Assessment and reassessment in accurate and regular documentation of pain score is essential to decrease their behaviour disturbance and evaluating the continuity care and improved quality of life in elderly
A patient is admitted to Nightingale Community Hospital to the surgical unit following an infection to a post-op wound. There were several deficiencies found on the patient’s tracer audit once the patient was admitted to the hospital. One deficiency that was found was that the patient was given medication related to pain and the patient was not reassessed properly per Joint Commission Standards (JC). The deficiency found is within the pain assessment policy of the hospital.
I am so happy you picked pain as your ICP project. Pain, in my eyes, has always been all encompassing. It can affect sleep, ability to move around, eating, healing, breathing, mood and relationships (Shega, Tiedt, Grant, & Dale, 2014). Personally when I am in severe pain I really do not want people around and it affects every aspect of my life. To think that persistent pain affects 80% of elderly residents in nursing homes and 50% of community dwellers, and we still do not treat this properly (Veal& Peterson, 2015).
Then, I can be able to evaluate outcomes. During my assessment of Sara Lin, I was able to find out that she was experiencing a pain level of 6 and was having a hard time breathing. If I had not asked her and assessed her pain, I would not have found out that she was having a hard time breathing and that I needed to educate her about using an incentive spirometer to help ease her breathing, which I actually forgot to do during my first attempt at this scenario. During this scenario, I also learned how important patient education is to help my patient understand her situation and how she should properly care for her condition. For instance, I had forgotten during my first attempt to educate Sara about proper wound care.
It is vital to put the patient at the midpoint of their own concern. Bedside reporting motivates staff responsibility and working as a group. Using a harmonized device will keep reports reliable and make sure all relevant information
In this crosspost, the author will elaborate on the original threaded discussion by Ellerbee Mburu, Vail, and Barlow and add additional information on pain assessment and management. Healthcare providers are the major group of healthcare professional who perform crucial functions in delivering and providing nursing care to inpatient and outpatients. As mentioned in the threaded discussion by Ellerbee, Mburu, Vail, and Barlow, undertreated pain causes unnecessary distress and negatively affects the quality of life. In additional to the original threaded discussion, pain is a factor that is thought of differently by many. It has been added as the fifth vital sign and is considered to be subjective.
We all know that pain is usually one of the major complaint of patients with chronic problems or those recovering post operatively thereby making pain evaluation a fundamental requisite in the outcome assessment during hospital visits. Interpreting the data from a pain assessment scale is not as straightforward as it may seem since the provider must consider the intensity, related disability, duration, and affect to define the pain and its effects on the patient (Williamson & Hoggart, 2005). Pain rating scales are used in the clinical settings to measure pain and these include Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), Numerical/numeric Rating Scale (NRS) (Haefeli & Elfering, 2006). Each scale is unique on its own in terms of sensitivity and simplicity that generates data that can be statistically analyzed for audit purposes. The EHR in our hospital utilizes the three rating scales mentioned as part of the pain assessment tool to measure pain that sets the tone for the direction of the type of pain management will .be given to the
The article Advance Care Planing - A Primer, which written by Karishma Taneja, Puneet Sayal since 2015 summer. The major theme in this article which is about pain assessment, the substitute decision making (SDM), the end of life (EOL) care, Ethics of Care and advance care plaining (ACP). Advance care plaining (ACP) which is an individuals make decisions that people who can arrange their own spirit of the time, through the default instructions. It can indicate that he/she does or does not wish to receive medical care, when he/
Providers may have limited time so they rely on the nurses to recognize the requirements for different pain medication and recommend what medications have worked for the patients in the past. Additionally, becoming comfortable with SBAR will help build confidence when communicating with other medical staff members. Communicating with other medical staff members is very important, but recognizing pain in a patient is of more importance. Early identification of pain in a post-surgical patient is important in overall pain management.
Senior Care and Pain Management One of the fears of growing old is that chronic pain will be a part of everyday life. While many seniors do deal with pain as a complication of illness or injury, pain is not a normal part of aging and does not need to be so. There are two major categories of pain: acute pain and chronic pain. Acute pain is pronounced and has a short duration. This type of pain is the body 's way of telling you there is something wrong.
Cheatle, Comer, Wunsch, Skoufalos, and Reddy (2014) in their article encourage healthcare providers to make use of psychological screening because there is a correlation between opioid abuse and depression. Another recommendation is that sleep assessment helps in pain management because Cheatle et al stated that opioids based on studied are known to affect sleep in people with chronic pain and SUDs. Lastly, the Authors further suggest that the effect of the opiates be measured by making use of the patient self-reporting
There are ranges of specialists who work on the rehabilitation team, each member of the team has a goal to help patient with a focus of promote QOL. The Case Managers are will be the primary contact person, with whom patient and family/caregiver can direct raise matters and ask for information. It is advised that a neuropsychologist should conduct a cognitive and behavioural/emotional assessment. Cognitive include perception and awareness, orientation, memory, though processing, problem solving, personality and decision making. Behavioural/emotional include emotional status, mood changes, adjustment difficulties, personality changes, inappropriate sexual behaviour, motivation level, substances misuse, depression, anxiety and psychosis.
Dementia is a set of neurodegenerative diseases high prevalence and high personal, family and social impact. During the course of the disease, patients become more dependent on daily life activities, which can result in institutionalisation (Gerrish, and Lacey, 2010). Parallel to cognitive impairment, dementia patients also develop behavioral and psychological symptoms known as neuropsychiatric symptoms. The agitation has been identified as a stressor for the patient and caregiver, which often leads to physical limitations, use of drugs, institutionalisation, and decreased quality of life of the patient and caregiver burden.
Psychological Assessment and Management of Chronic pain Evaluating a chronic pain condition from a biological perspective is limiting, and often fails to fully explain the patient’s symptoms. In contrast to the biomedical model, which explains pain purely in terms of pathophysiology, the biopsychosocial model views pain, suffering and disability, as the result of dynamic interactions among biological, psychological, behavioral, social, cultural and environmental factors. Consequently, assessment requires not only the examination of the biological dimension, but of the psychological and social dimensions as well. A patient’s experience of pain and response to any treatment for pain are affected not only by biologically determined nociceptive (nervous system transmission) processes, but also by psychological factors such as mood (for example, depression, anxiety) and appraisals (thoughts and beliefs about the pain), as well as by psychosocial factors such as the responses of others (for example, family, friends,
Dementia is one of the most feared diseases and expensive to society currently. It is defined as a clinical syndrome of acquired cognitive impairment that determines decrease of intellectual enough capacity to interfere social and functional performance of the individual and their quality of life. It is a known fact that patients tend to express themselves through their behaviour and expect their carers to understand this notion. The diverse kinds of causes of different behaviours are inability to communicate, difficulty with tasks, unfamiliar surroundings, loud noises, frantic environment, and physical discomfort. Many diseases can cause dementia, some of which may be reversible.
The following sections will further explain the definition of pain, acute and chronic pain, pain theories, repercussions of untreated pain, pharmacologic and non-pharmacologic interventions to acute pain. IMPROVING NURSES’ PAIN MANAGEMENT IN PACU 14 Definition of pain The International Association for the Study of Pain in 1979, defines pain as “unpleasant sensory or emotional experience associated with actual or potential tissue damage”