pain management in the surgical/trauma patient

Pain Management in the Surgical/Trauma Patient

Antoinette McNeil, BSN, RN, CCRNAnalysis of Evidence-Based Practice

Professor: Chioma Nwachukwu, DNP, RN2012

There are over 77 million people suffering from pain

HCAPHS score 63-74% pain controlled Pain is what the patients states and occurs

where the patient say is does Complications of unmanaged pain Goal of pain management

Introduction

Leininger’s Theory: Culture, Care Diversity and Universality

Care is focus and essence of nursing Culture care expression diverse but has

commonalities that exist Understand patient’s culture Nurses needs to look at their beliefs and values as

they care for patients in other cultures

Nursing Theory/Model

Cost of lost workdays exceeds $100 billion yearly Medicare cost exceeds $124 million yearly for

pain treatment and disability cost for chronic pain Increase risk of morbidity and mortality from

◦ Pneumonia◦ DVT◦ Pulmonary Emboli◦ Myocardial Infarction◦ Confusion◦ Chronic Pain

Impact of Problem

Multidisciplinary Approach

Nursing assessing and reassessing for pain Nurses administering pain medication around the

clock Physicians ensuring that patients pain is managed

properly and assist in improving practice Anesthesiologist responsible for 24 hours for post-

operative pain management Leadership and Administration to provide

administrative and financial support for pain management plan

Use of acetaminophen and or NSAID’s before surgery

Epidural analgesia Bupivacaine collagen sponges Elastomeric pumps Fentanyl iontophoretic transdermal system

Evidence-Based Practice

Patient education Physician education Pharmacist education Physical and Occupational therapy

education Nursing education

Methods to Improve Pain Management

HCAHPS survey Length of stay Complications Working together

Evaluation and Conclusion

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Dihle, A., Bjolseth, G., & Helseth, S. (2006). The gap between saying and doing in postoperative pain management. Journal of Clinical Nursing, 15(), 469-479.

Dusek, J. A., Finch, M., Plotnikoff, G., & Knutson, L. (2010, March). The Impact of Integrative Medicine on Pain Management in a Tertiary Care Hosptial. Journal of Patient Safety, 6(1), 48-51.

D’Arcy, Y. (2011). Compact Clinical Guide to Acute Pain Management An Evidence-Based Approach for Nurses. New York, NY: Springer

Goodman, G. R. (2003, April-June). Outcomes Measurement in Pain Management Issues of Disease Complexity and Uncertain Outcomes. Journal of Nursing Care Quality, 18(2), 105-111

Layzell, M. (2008, April 10). Current interventions and approaches to postoperative pain management. British Journal of Nursing, 17(7), 414-419.

Leegaard, M., Watt-Watson, J., McGillion, M., Costello, J., Elgie-Watson, J., & Partridge, K. (2011, July/August). Nurses’ Educational Needs for Pain Management of Post-Cardiac Surgery Patients A Qualitative Study. Journal of Cardiovascular Nursing, 26(4), 312-320.

Reference

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