Pain Assessment & Management
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Transcript of Pain Assessment & Management
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Laurie Soper MS, MSN, APRN -CAcute Care Clinical Education Specialist
Pain Assessment & Management
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Identify the appropriate GPRMC policies and procedures related to pain assessment and management
Discuss the pain scales used at GPRMC (Wong- Baker, FLACC, Adult Non-verbal, & NIPS)
Demonstrate knowledge by completing the post test with a score of 90% or more
Objective
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GPRMC has a strong commitment to Pain Management
Our patients have a right to:
Information about pain and pain reliefA concerned staff committed to pain
prevention and managementHealth professionals who respond quickly
to reports of painHealth professionals who believe your
report of painState of the art pain management
Pain Management at GPRMC
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Pain Assessment & Management Policy
6010-0007
Patient Controlled Analgesia Policy
6265 I L MED 002
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Document the patient’s responses during the following:
At admission
After any known pain producing event
With each new report of pain
Routinely at regular intervals (at least every shift)
Pain Assessment
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Pain shall be assessed and pain intensity documented within 60 +/- 15 minutes after parenteral drug therapy
Pain shall be assessed and pain intensity documented within 90 +/- 15minutes after oral drug therapy
Pain shall be assessed at a minimum every 4 hours during the first postoperative day following major surgery during the inpatient admission
Pain shall be assessed and pain intensity documented every 4 hours and PRN while patient has a PCA/PCE
Pain Assessment Cont.
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Wong Baker/Numeric Pain Scale
FLACC Scale
Adult Non Verbal Pain Scale
N-PASS
Pain Scales
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Wong-Baker/Numeric Scale
For children and adults who demonstrate the ability to use the scale by choosing a face or stating a number that indicates their pain level
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For infants and children who are preverbal or children up to three years of age who are unable to use the Wong-Baker (faces) Scale
The FLACC Scale
FLACC PAIN ASSESSMENT SCALEO 1 2
FACE No particular expression or smile
Occasional grimace or frown, withdrawn, disinterested
Frequent to constant frown, clenched jaw, quivering chin
LEGS Normal position or relaxed
Uneasy, restless, tense
Kicking or legs drawn up
ACTIVITY Lying quietly, normal position, moves easily
Squirming, shifting back and forth, tense
Arched, ridged, or jerking
CRY No Cry (awake or asleep)
Moans or whimpers, occasional complaint
Crying steadily, screams or sobs, frequent complaints
CONSOLABILITY Content, relaxed Reassured by occasional touching, hugging, or “talking to”; distractible
Difficult to console or comfort
FaceLegsActivityCryConsolability
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For adults that are unable to self report their level of pain for whatever reason (critically ill, intubated, sedated, comatose, confused
Adult Non Verbal Pain Scale
Categories 0 1 2
FACE No particular expression or smile
Occasional grimacing, tearing, frowning, wrinkled forehead
Frequent grimace, tearing, frowning, wrinkled forehead
ACTIVITY(Movement)
Lying quietly, normal position
Seeking attention through movement or slow, cautious movement
Restless, excessive activity and/or withdrawal reflexes
GUARDING Lying quietly, no positioning of hands over areas of body
Splinting areas of body, tense
Rigid, Stiff
PHYSIOLOGIC IStable vital signs (no change in past 4 hours)
Change over past 4 hours if any of the following: SBP>20mmHGHR>20/minRR>10/min
Change over past 4 hours in any of the following:SBP>30mmHG,HR>25/min,RR>20/min
Physiological II Warm, dry skin Dilated pupils, perspiring, flushing
Diaphoretic, pallor
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Neonatal Infant Pain Scale (NIPS)A behavioral assessment tool for measurement of pain in preterm and full-term neonates.
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Document pain assessment at minimum every shift
Documentation can be completed:Vital Sign FlowsheetHourly Patient Rounding FlowsheetShift Assessment Flowsheet
Ensure document correct scale use for pain assessment
Documentation
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All patients should be educated on pain during admission and throughout their hospital stay
Education is the key to successful pain management
Education
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Questions ??