PAIN MANAGEMENT Help me HELP ME!!

Transcription

1 PAIN MANAGEMENT Help me HELP ME!!

2 RECOGNIZING AND IDENTIFYING PAIN Trust what the resident says Recognize other words to describe pain Implement the appropriate interventions to relieve their pain

3 WHAT DOES PAIN MEAN? PAIN- An unpleasant sensory and emotional experience that can be acute, recurrent, or persistent ACUTE PAIN- Pain of abrupt onset and limited duration often associated with an adverse chemical, thermal or mechanical stimulus such as injury, trauma and acute illness

4 BREAKTHROUGH PAIN- Refers to an episodic increase in pain (flare-up) in someone whose pain is generally being managed by his/her current medication regime INCIDENT PAIN- Refers to pain that is typically predictable and is related to a precipitating event such as movement (e.g., walking, transferring, or dressing) or certain actions (e.g. disimpaction or wound care)

5 PERSISTENT PAIN OR CHRONIC PAIN- Refers to a pain state that continues for a prolonged period of time or recurs more than intermittently for months or years

6 Pressure Achy Hot Throbbing Stabbing Itching Flickering Tugging Tiring OTHER PAIN WORDS

7 COMMON MISCONCEPTIONS ABOUT PAIN Normal part of aging Elderly can tolerate more pain Sign of weakness Attention-seeking behavior

8 PAIN INDICATORS Groaning, crying, whimpering, screaming Grimacing, frowning, fright, jaw clenching Limping Increased vital signs, heart rate, respiration, blood pressure Resisting care, distressed pacing, irritability, distressed mood, decreased social activities Guarding a limb or other body part, rubbing a specific location of the body Difficulty eating or loss of appetite Difficulty sleeping or insomnia

9 Intensity Descriptions Pattern Location Radiation Frequency Timing Duration PAIN CHARACTERISTICS

10 ASSESS FOR PAIN Thorough pain assessment Prior treatments Pain characteristics Impact of pain on the quality of life Factors that may precipitate or aggravate pain Strategies that may lessen pain Additional symptoms associated with pain Current medications Residents goals for pain management

11 WHEN SHOULD PAIN BE ASSESSED? On admission At readmission At each MDS assessment With each change in condition Reassess with worsening pain, this can indicate a change in condition

12 DIFFERENT PAIN SCALES Numerical pain scale Verbal pain scale Wong-Baker faces scale Analogue pain scales Abbey Pain Scale (for residents with dementia) FLACC (for non-cognitive or nonverbal residents)

13 MANAGE PAIN Establish a pain management plan Establish a goal of pain management Educate on the side effects of pharmacological pain management Schedule pain medication around the clock rather than prn for daily pain to optimize the effectiveness

14 TIMING MEDICATIONS FOR MAXIMUM BENEFIT Anticipate painful situations and implement interventions to prevent or minimize pain Administer pain medications a half hour before painful dressing changes or physical therapy Reassess the resident s response to pain medication and interventions

15 MONITOR THE PAIN, AND THEN MODIFY THE PLAN Ongoing monitoring and evaluation is needed to ensure pain management goals are being met Accurately monitor changes in pain Rate the pain using the same pain scale used in the initial assessment Always accept the resident s reported level of pain

16 Monitor the development of any symptoms and identify their origin (constipation, urinary retention, nausea and vomiting) If these symptoms are a result of the pain medications, these should be adjusted to maximize effective pain relief and minimize complications

17 A policy and procedure to monitor the resident s and family member s satisfaction with pain control should be in place. A quality assurance committee should audit the pain management process