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Running head: THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT 1
The Importance of Education for Effective Pain Management
Erica Rene Lewis
Our Lady of the Lake College
December 3, 2013
Keeley Dupuy
NURS: 4915
Capstone
THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
Abstract
The purpose of this paper is to investigate the effectiveness of post licensure pain management
education, through the use of continuing education for nurses, working in a clinical care setting.
“Pain management is an important component of postoperative care in patients of all ages”
(Smith, 2012, p. 1) and providing comfort for the patient both physically and emotionally is the
job of the nurse. However, patient’s pain is going untreated due to the nurses’ inadequate
knowledge of pain assessment and management. A quasi-experimental design (in the form of a
questionnaire) was completed by six nurses working on the Trauma-Neuro Critical Care Unit
(TNCC) of Our Lady of the Lake Regional Medical Center to determine if a continuing
educational program focusing on pain assessment would improve the nurse’ ability to manage
the pain level of the patients in their care. Of the six participants, two representing 22% scored
below an 80% on the questionnaire. Based on the results, there is a clear need for the
establishment of clinical pain management guidelines and pharmacological/non-pharmacological
training. This training would improve the nurses’ ability to effectively assess pain levels and to
proficiently provide effective pain management care to all patients.
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
Table of Contents
Introduction........................................................................................................................................... 4
Literature Review................................................................................................................................ 5
Methods................................................................................................................................................ 10Design................................................................................................................................................................ 10Subjects and settings.................................................................................................................................... 11Limitations...................................................................................................................................................... 12Data evaluation and analysis.................................................................................................................... 12Ethical considerations................................................................................................................................. 12
Results................................................................................................................................................... 13
Conclusion............................................................................................................................................ 13
References............................................................................................................................................ 15
Appendix.............................................................................................................................................. 17
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
The Importance of Education and Pain Management
Introduction
“Pain is an unpleasant sensory and emotional experience associated with actual or
potential tissue damage”, and is one of the major reasons people are seeking medical care
assistance (International Association for the Study of Pain: Pain Definition, 2011). “Pain is a
subjective phenomenon and is triggered by a number of factors such as: age, sex, culture, and
previous experiences with pain” (Oware-Gyekye, 2008). However, an important factor to note is
that pain tolerance and sensitivity is different for men, women and children. Each individual’s
experience with pain should be addressed through effective pain management and control. For
example, children possess limited capability of pain expression because of its unfamiliarity, and
this can hinder them from communicating what they are experiencing. Whereas, as adults we
adapt the necessary skills to either suppress or seek health care assistance when pain becomes
unbearable. There is no evidence that our reaction to pain differ based on gender, however,
“cultural influence on gender may produce different expressions of pain” (Oware-Gyekye, 2008,
p. 51). In addition, a communication barrier, such as language, can also affect how health care
providers manage pain in their patients. Pain can be a debilitating experience and its existence
can hinder a person from performing their basic life skills, such as walking, bathing, or caring for
themselves, thus affecting their quality of life. As a result, pain management should be held to
the highest regard for all nurses in order to ensure that their patients are comfortable while under
their care.
Many nurses do not trust the judgment of their patient’s self- reported pain level when
asked to rate their pain on a scale of 1-10 (10 being the most severe). Consequently, there has
been a consistent theme in the literature for a lack of knowledge concerning pain assessment and
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
management (Al-Shaer, Hill, & Anderson, 2011). Therefore, due to nurse’s inadequate
knowledge of assessment and management of pain, the patient’s pain is going untreated. Al-
Shaer et al. (2011) mentions, “Nurses need current knowledge and appropriate attitudes
regarding pain assessment and management regardless of patient age and origin of clinical
practice” (p. 7). Patients enter into the care of hospitals for various reasons, and each department
caters specifically to the patients’ needs, including pain management. Although the severity of
patient’s pain levels differs from unit to unit, the nurse’s knowledge of pain management and
assessment should be consistent.
This paper will discuss the lack of knowledge regarding pain management among nurses
from varying units. In addition, the purpose of this paper is to review literature that investigates
the effectiveness of post licensure pain management education, in the form of continuing
education, for nurses working in ta clinical setting. I hypothesize that establishing clinical pain
management guidelines and pharmacological/non-pharmacological training will enable nurses to
adequately assess pain levels and proficiently provide effective pain control.
Literature Review
Allcock et al. (2011) states “today’s critical care nurses are faced with the challenge of
providing effective and efficient pain management while trying to sustain the lives of their
patients.” Allcock et al. (2011) conducted a study in order to explore the challenges of a nurse in
the critical care unit in regards to providing pain management. The findings from this qualitative
study, which are similar to those found in McNamara, Harmon & Saunders (2012) study, shows
that the problem in regards to pain management is due to the lack of the critical care nurses’
ability to recognize and promptly provide treatment for patients in pain.
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
To manage patient’s pain successfully, nurses need to know the physiology of pain,
myths and misconceptions about pain, how to assess pain, patients’ behaviors when
in pain, pharmacological and non-pharmacological pain-management techniques and
ethical issues in pain management (Ferrell et al.1993, Wang & Tsai, 2009 pg. 3189).
The participants from McNamara et al. (2012) mixed method experimental study stated,
“pain assessment should be carried out every 24 hours, as opposed to one to two hourly” (p.962).
However, contrary to their beliefs, pain assessment should be carried out every four hours. If
pharmacological interventions are utilized, its effectiveness should be evaluated 30 minutes after
the patient takes the medication. Medication follow-up is an important task that nurses are
required to perform in order to evaluate the effectiveness of the pain control measures being
taken. In addition, pain management is an interdisciplinary intervention that requires the
collaboration of nurses, health care professionals, the patient as well as family members. The
nurses in Allcock et al. (2011) study relied heavily on the opinions of pain expert’s, which
included the anesthetist, intensivist and acute pain team when providing pain management
interventions, because they felt they lacked similar expertise.
Recent studies on the issue of pain management suggest that there are limitations in
the area of nursing knowledge related to pain management practice and there is a
need for standardized pain management to guide nurses in decision making
(McCaffery et al. 2000, Jacobi et al. 2002, Puntillo et al. 2002, Aslan et al. 2003,
Shannon & Bucknall 2003, Allcock et al. 2011 p.1258).
The nurses expressed the need for clinical guidelines in order to guide their clinical
practice and reduce the under treatment of patient’s pain (Allcock et al. 2011). Wang et al.
(2010) states that the under treatment of the patients pain on the ICU unit is due to the improper
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
documentation of the patients stated pain level. “ICU nurses have consistently rated their patients
pain lower than the patient’s self-reported pain” (Puntillo et al. 1997, Shannon & Bucknall 2003,
Wang et al. 2009 p.3194).
The limitations of the nurses knowledge of pain management due to their lack of clinical
education and training impedes their clinical judgment when collaborating with healthcare team
members, the patient and family. Wang et al. (2009) found within their cross-sectional study that
the lack of knowledge of ICU nurses was related to their educational level, nursing clinical
position, type of ICU and hospital accreditation category. “Nurses need to be equipped with
adequate knowledge of pain management in making accurate and relevant clinical judgments”
(Allcock et al. 2011, pg. 1259). Therefore, non-verbal and verbal cues should be viewed during
the assessment and evaluation of pain management. It is imperative that nurses not only be
knowledgeable, but trained on how to properly intervene for their patients when they’re
experiencing a pain level outside of their acceptable range.
Education alone may not change clinical nursing practice. Health care organizations
need to institutionalize pain management practices by incorporating basic principles
of pain assessment and management into daily practice (Berry &Dahl, 2000; Al-
Shaer et al. 2011, pg. 10)
As stated, education alone does not make a nurse competent in providing pain control.
However, nurses must be equipped with the necessary skills in order to adequately identity and
meet the needs of all patients’ pain levels. “The participants felt that when training was
provided, nurses’ knowledge was retained and they felt more confident in caring for their
patients” (Allcock et al. 2011, pg. 1258). Information is retained1 when one is able to skillfully
1 Retain -the ability to keep in mind or memory (Merriam-Webster, 2013).
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
apply2 what one has been taught. Although knowledge about pain management is a necessity in
order to practice as a nurse, training and clinical experience is also a factor in the continuing
development of a nurse’s practice.
20.3% admitted that they lacked the ability to assess pain and 23.8% thought that
they did not have adequate knowledge about dealing with pain. Showing a gap
between ICU nurses’ actual knowledge and their perceived knowledge (Wang &
Tsai, 2009, p. 3194).
NcNamare et al. (2012) & Machira, Kariuki & Martindale (2013) both found within their
studies that there was an improvement in the attitudes and knowledge of those nurses who
participated in educational programs. As stated in Machira et al. (2013) there is a “need for
continuous professional development (CPD), as professional development ensures that nurses’
knowledge and skills are kept up to date and remains relevant (Quinn & Hughes, 2007),
improving patient care” (pg. 345). In order to make sure a nurse remains competent post
licensure, pain management experience should not stop in the classroom but should continue in
the clinical environment. According to Wilson (2007), though educational programs contribute
to the increase in knowledge regarding pain, “it is the clinical environment that has a significant
influence on the development and application of knowledge on pain management” (McNamara
et al. 2012, p. 958). Pain management education and training should be consistent across all
nursing academia since pain is a sensation that is universally pain. Nurses on different units tend
to possess varying degrees of knowledge toward pain management due to the different levels of
experience and education.
The nurses understanding and actions to control pain in the patient are essential for the
well-being of the patient. The registered nurses (RNs) of Al-Shaer et al. (2011) study were
2 Apply -to put into operation or effect (Merriam-Webster, 2013).
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
competent in their understanding of pain management and assessment. However, they lacked
knowledge of pharmacological intervention. In regards to pharmacological intervention a
discrepancy exited in the nurses’ knowledge of side effects to medication, medication dosage and
duration of action (Al-Shaer et al. 2011). However, analgesics use isn’t the only way to suppress
painful stimuli. “Some studies have shown that relaxation therapy 3 is effective in decreasing
pre-operative anxiety in surgical patients, in decreasing postoperative pain and in speeding
postoperative recovery” (DeMarco-Sinatra 2000, Schaffer &Yucha 2004, Lin, Chiang, Chiang
&Chen 2008, p. 2033).
Lin et al. (2008) conducted a quasi-experimental study showing that after nurses
completed courses on relaxation therapy, they were more inclined to include this pain
management method into their practice. In the study conducted by Al-Shaer et al. (2011) there
were no significant differences noted between nurses based on educational level. The veteran and
oncology nurses were considerably more knowledgeable about pain as opposed to nurses on a
different unit. In addition, the oncology nurses advanced knowledge of assessment and pain
management is due to their “holistic and palliative approach, which are central to orientation and
continuing education for oncology nurses” (Al-Shaer et al. 2011, pg. 10). Although Dalton et al.
(1996) was unsuccessful in his attempt to conduct a continuing educational program on the
knowledge of pain management in cancer patients, palliative care is essential to the quality of life
of those with terminal illnesses and should be included in nurses’ health training (Machira et al.
2013).
Health policies are rules set in place within a society using decision making, planning,
and utilizing actions to achieve specific health care goal. Humana is a health care insurance
3 Relaxation Therapy – is the process of assisting an individual to retreat mentally from their surroundings through stilling thoughts, relaxing muscles and maintaining a relaxed state (Lin et al. 2008, p. 2034).
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
company whose pain management services for their members are provided through OrthoNet.
OrthoNet evaluates the medical necessity of the services and request any needed medical
records. The following services are provided through OrthoNet: pain infusion pumps (back and
neck pain only), spinal fusions, Epidural injections (outpatient only) etc.… (Humana , 2013).
“Patients and health professionals continue to report that pain in often inadequately managed in
hospitals and community settings” (Godfrey, 2005, Ogston-Tuck 2012, p. 514). When caring for
the older adult in a community the nurses must possess better assessment skills in order to better
detect pain in this population
Methods
Design
A quasi-experimental pre and posttest approach was taken in order to assess the effects of
an educational program on the nurse’s knowledge of pain assessment and management. A seven-
item pretest consisting of 5 assessment and 2 non-pharmacological questions (figure1) was
administered to evaluate the participant’s baseline knowledge of pain management. A posttest
would be administered following an online course. Information on how to develop a training
course was gathered from the Manager of Clinical Experiences in the training and development
department of the Our Lady of the Lake Regional Medical Center. In following the Institutional
Review Board (IRB) process certification would be obtained and a proposal would be composed
before conducting the study. The proposal would include the purpose of the research, plans on
how the research would be carried out and all the materials used to conduct the research.
However, before submitting a proposal an IRB application would be completed. A PowerPoint
presentation documenting pain management would be composed based on low scores achieved
in particular content areas regarding pain. The PowerPoint presentation would be reviewed and
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
evaluated by the Clinical Educator for flaws and redundancy. After evaluation and approval by
the Clinical Educator, the Training Specialist would upload it as a computer-based module onto
to the Decision Critical Application. Next, the modules would be assigned to each nurse based
their recorded score on the pre-test. Scores lower that 80% would require enrollment into the
online course. In order to gain access to their modules the nurses would enter their employee
login on a work based computer. The participants would be given six to eight weeks to complete
the online-based course. There would be three modules in this online course: assessment,
pharmacological and non-pharmacological pain interventions. If the participants do not complete
the modules within the allotted time frame they will be suspended without pay until it is
completed. In order to keep the nurses compliant with completing their course, the nurse
manager will be contacted electronically by email the fourth week after the modules have been
assigned to remind them of the nurses who are required to complete the modules.
Subjects and settings
The study would be conducted at Our Lady of the Lake Regional Medical Center. The
sample size would consist of six registered nurses (RNs) on the Trauma-Neuro Critical Care
(TNCC) unit. This is a 10-bed unit with two patients assigned to each nurse. Inclusion would be
based on having at least three years of clinical experience on the TNCC unit, hold a BSN degree,
providing direct patient care during the study and being an employee of the hospital where the
study is being conducted. Nurses were excluded if they had less than one-year experience on the
TNCC unit or a new nurse orientee.
Limitations
There were limitations to this study due to sample size and demographics of the nursing
staff. The participants were all female and only one unit was considered for this study. There was
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
a lack of randomization when selecting the participants. The pretest used in this study showed no
validity and reliability due to its lack of the evaluation of the nurses’ pharmacological
background and minute consideration of non-pharmacological items
Data evaluation and analysis
Data was collected using a pretest to evaluate the nurse beginning level of knowledge in
regards to pain management. All six nurses participated in completed the pretest. The
instruments used in this study were the Decision Critical Application and Microsoft Office
(Excel, PowerPoint &Word). The participant’s knowledge of the content presented in the
modules would be evaluated using a posttest to which they will have to make an 80% or higher
to be consider competent. The nurses’ were evaluated on a 7-point grading scale. The
participants would be given the same test in order to evaluate the effectiveness of the online
training.
Ethical considerations
Before conducting this study approval from the IRB of the research institute would first
have to be obtained. Permission to distribute the pre-test to the nurses on the unit was obtained
from the nurse manager. Participants were informed that entry into the study was completely
voluntary and that they could withdraw at anytime during the study period. It was explained that
consent would be implied if they choose to complete the pre-test. Before administering the pre-
test the purpose, both the benefits and penalization and selection criteria of the study were also
clearly explained. No identifying information was asked of potential participants. The nurses
were told that their results to both the pre and posttest would be made available to them and the
confidentially would be maintained through the use of codes, rather than names.
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
Results
One hundred per cent of the sample completed the pre test (n=6). Of the six participants
only two participants (22%) scored below an 80%. Table 1 shows how the nurses scored on the
pretest. Majority of the nurses on this unit was knowledgeable about how to assess their patients
for pain as represented by the test. The most frequently missed question pertained to non-
pharmacological interventions for pain, however some assessment questions were missed (Table.
2). Items 5 and 6 of the pre test explored non-pharmacological intervention for pain and 22% of
the participants answered correctly. The effect of the pain management education program on
the nurses’ knowledge could not be evaluated because a posttest was not administered. Due to
the lack of reliability of the pre/posttest and the fact that only one unit was considered this study
would not contributed nor helped resolve the issue of the nurses’ lack of knowledge of pain
management.
Conclusion
In the closing of this paper it has been discovered that patients pain have been
undertreated due to the lack of pain management knowledge on behalf of the nurse.
Improvement in the pain management skills of the nurses is imperative because they are involved
in direct care of their patients. Nurses are responsible for providing both pharmacological and
non-pharmacological pain relieving interventions in order to increase their patient’s outcomes.
Although the test lack reliability the results of this study indicates majority of the nurses were
knowledgeable about pain management. With advancement in professional knowledge and skills
of the nurse, improvement can be made in the quality of care of the patient and shorten their stay
in the hospital. Because nurses in different departments deal with varying degrees of pain, and
most come in contact with it more often than others. Some nurses’ lack the clinical experience
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
needed to maintain the knowledge they once obtained. However, with the incorporation of
continuing educational programs nurses’ knowledge of pain management and assessment has
said to be improved.
References
1.
Allcock, N., James, V., & Lathlean, J. (2011). Challenges faced by nurses in managing pain in critical care setting. Journal of Clinical Nursing , 1254-1260.2. Al-Shaer, D., Hill, P. D., & Anderson, M. A. (2011). Nurses' Knowledge and Attitudes
Regarding Pain Assessment and Intervention. MedSurg Nursing , 1-10.
3. American Nurses Credentialing Center. (2013). ANNC. Retrieved November 25, 2013, from
ANNC: Pain Management Nurse Exam Sample Questions:
http://www.nursecredentialing.org/PainMgmt-SampleTest.aspx.
4. Aslan FE, Badir A & Selimen D (2003) How do intensive care nurses assess patients’ pain?
Nursing in Critical Care 8, 62–67
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT
5. Berry, P.H., & Dahl, J.L. (2000). The new JCAHO pain standards: Implications for pain
management nurses. Pain Management Nursing, 1(1), 3-12.
6. DeMarco-Sinatra J (2000) Relaxation training as a holistic nursing intervention. Holistic
Nursing Practice 14, 30–39.
7. Ferrell BR, Grant M, Ritchey KJ, Ropchan R & Rivera LM (1993) The pain resource nurse
training program: a unique approach to pain management. Journal of Pain & Symptom
Management 8, 549–556.
8. Flanagan J (1954) The critical incident techniques. Psychological Bulletin 51, 327–358.
9. Godfrey H (2005) Understanding pain, part 1: physiology of pain. Br J Nurs
14(16):846-52
10. Humana . (2013). Humana: Pain Management . Retrieved November 30, 2013, from
Humana : https://www.humana.com/provider/medical-providers/education/referral/pain-
management
11. International Association for the Study of Pain: Pain Definitions [Retrieved 10 Sep 2011].
"Pain is an unpleasant sensory and emotional experience associated with actual or
potential tissue damage, or described in terms of such damage" Derived from Bonica JJ.
The need of a taxonomy. Pain. 1979;6(3):247–8. doi:10.1016/0304-3959(79)90046-0.
PMID 460931.
12. Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D & Wittbrodt ET (2002) Clinical
practice guidelines for the sus- tained use of sedatives and analgesics in the critically ill
adult. Critical Care Medicine 30, 119–141.
13. Lin, P.-C., Chiang, H. W., Chiang, T.-T., & Chen, C.-S. (2008). Pain management:evaluating
the effectiveness of an efucational programme for surgical nursing staff. Journal of
Clinical Nursing , 2032-2040.
14. Machira, G., Kariuki, H., & Martindale, L. (2013). Impact of an educational pain
management programme on nurses' pain knowledge and attitudes in Kenya .
International Journal of Palliative Nursing , 341-345.
15. McNamare, M. C., Harmon, D., & Saunders, J. (2012). Effects of education on knowledge,
skill and attitutdes around pain . Bristish Journal of Nursing , 958-963.
16. Oware-Gyekye, F. (2008). Pain managemnent: The role of the Nurse . West African
Journal of Nursing , 50-54.
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17. Puntillo KA, Kehrle K, Gleeson S & Nye P (1997) Relationship between behavioral and
physiological indicators of pain, critical care patients’ self-reports of pain and opioid
administration. Critical Care Medicine 25, 1159–1166.
18. Puntillo K, Stannard D, Miaskowski C, Kehrle K & Gleeson S (2002) Use of a pain
assessment and intervention nota- tion (P.A.I.N.) tool in critical care nursing practice:
nurses’ evaluations. Heart and Lung 31, 303–314.
19. Quinn FM, Hughes SJ (2007) Quinn’s Principles and Practice of Nurse Education. 5th edn.
Nelson Thornes Limited, UK
20. Schaffer SD & Yucha CB (2004) Relaxation and pain management: the relaxation response
can play a role in managing chronic and acute pain. American Journal of Nursing 104,
75–76, 78–79, 81–82.
21. Shannon K & Bucknall T (2003) Pain assessment in critical care: what have we learnt from
research. Intensive and Critical Care Nursing 19, 154–162.
22. Smith, N. (2012, December 7). Pain Management in Adults, Posteroperative. Nursing
Practice & Skills , pp. 1-4.
23. Wang, H.-L., & Tsai, Y.-F. (2009). Nurses' knowledge and barriers regarding pain
management in intensive care units . Journal of Clinical Nursing , 3188-3195.
Appendix
Figure 1.By completing the survey you are implying informed consent. There is no risk to completing this competency test
1. Which statement indicates the development of opioid tolerance?a) Larger doses of opioids are needed to control pain compared to several weeks
earlier.b) Stimulants are needed to counteract the sedating effects of opioids.c) The patient becomes anxious about knowing the exact time of the next dose of
opioid.d) The patient no longer experiences constipation from the usual dose of opioid.
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2. When assessing a patient's cultural beliefs about pain, the pain management nurse asks about:
a) A family history of pain.b) Home remedies used to treat pain.c) The frequency of visits to health care facilities.d) The patient's dietary preferences.
3. When assessing a patient for possible side effects related to acetaminophen (Tylenol), the pain management nurse asks the patient about the use of:
a) Alcohol.b) Marijuana.c) Opioids.d) Tobacco.
4. A 45-year-old male patient reports pain in his foot that moves up along his calf. The patient states, "My right foot feels like it is on fire." The patient further describes that he has no previous history of injuries or falls, and that his pain started yesterday. Which components of pain assessment has the patient reported?
a) Aggravating and alleviating factorsb) Exacerbation, and associated signs and symptomsc) Intensity, temporal characteristics, and functional impactd) Location, quality, and onset
5. Which behavioral therapy works best to relieve pain with muscle tension and spasms in patients who are anxious about their pain?
a) Distractionb) Hypnosisc) Relaxationd) Stress management
6. Which non-pharmacologic intervention is difficult to use with older adults who are cognitively impaired?
a) Aromatherapyb) Distractionc) Guided imageryd) Heat application
7. The pain management nurse notices a male patient grimacing as he moves from the bed to a chair. The patient tells the nurse that he is not experiencing any pain. The nurse's response is to:
a) Clarify the patient's report by reviewing the patient's nonverbal behavior.b) Confronting the patient's denial of pain.c) Obtaining an order for pain medication.d) Supporting the patient's stoic behavior
(American Nurses Credentialing Center, 2013)
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Table 1. Distribution of Letter Grades for the Pain Management Knowledge Pretest
(N=6)Grades Percent Correct N (%)
A 94-100 0B 87-93 0C 80-86 4 (66. 7)D 77-79 1 (16.7)F ≤74 1 (16.6)
Table 2.
Most Frequently Missed Items
Incorrect
Which behavioral therapy works best to relieve pain with muscle tension and spasms in patients who are anxious about their pain
66.7%
The pain management nurse notices a male patient grimacing as he moves form the bed to a chair. The patient tells the nurse that he is
not experiencing any pain. The nurse’s response is to:
33.3%
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THE IMPORTANCE OF EDUCATION FOR EFFECTIVE PAIN MANAGEMENT 20