Poor Pain Management In Post-Op Care

The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety

According to surveys, up to 80% of patients reported moderate to severe post-surgical pain, which can sometimes be left undertreated (Sinatra et al., 2005). Postoperative pain is generally managed with opioids, which carry numerous side effects. Side effects can be bothersome and possibly cause a delay in the postoperative healing process (Beard, Leslie, & Nemeth, 2011). IV acetaminophen can possibly decrease opioid consumption, minimize side effects, increase patient satisfaction, and decrease costs (Wininger et al., 2010). The purpose of this paper is to dive further into the research to present data on the effectiveness of IV acetaminophen in decreasing opioid usage and whether it produces an additive effect causing more effective pain management in the postop patient.

Pain is formally identified as a problem of global proportions by WHO and postoperative pain is one of the most common types of pain that has raised a public health concern by various societies in Australia, USA and Europe. It affects roughly 40% of surgical patients who experiencing a moderate to severe pain. It is important that graduate RNs have the knowledge and clinical skills to care for these patients as management of acute post-op pain has posed a significant challenge in surgical specialities for the past 50 years.

This study was conducted in a National Cancer Institute in western United States and was supported by the Institutional Review Board. The sample included 53 nurses, both males and females from medical and surgical oncology units. The study was performed using National Comprehensive Cancer Network clinical practice guidelines as the research method. The instruments used to measure change was a Demographic Evaluation Tool, Nurses’ Knowledge and Attitude Survey Regarding Pain (NKASRP), Pain Reassessment Data Tool (PRDT), and a Pain Competency Evaluation (PCE) Tool. Interventions for the study included one-to-one feedback regarding pain reassessment practices and mandatory nursing rounds to discuss pain related

Throughout my life, I have undergone many dental operations, giving me first hand experience on post-operative pain and it’s management. After being exposed to long term care settings for clinical, I would like to take this opportunity to increase my knowledge on a topic that, besides my own personal experiences, I have not been heavily exposed to in a learning environment. Pain, defined in Kozier et al. (2014) as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage” (p. 739), is inevitable to some degree after surgery; making its management a crucial for a healthy recovery. The recommendations within both the Registered Nurses’ Association of Ontario’s (RNAO) (2013) Best Practice Guideline

According to Trail-Mahan et al., (2016), there are several obstacles to successful pain management such as irresponsible behavior, imprecise, inadequate repeated assessments, and inadequate analgesics dispensation execution and inefficient communication between nurses and patients and mostly among nurses mostly at change of shift. Lack of education among healthcare workers about proper pain medication dosing and unjustified worry about controlled substance addiction lead to poor pain administration. Patients may not have any understanding of the pain scale or sometimes they are afraid to report pain. However, because of the lack of education, patients may ask for pain medication when the pain is very severe and the medication is not enough to take care of the pain. Also, sometimes their fear of dependency is greater than their fear of the pain they are in. As

Surgery causes predictable tissue damage leading to the expected outcome of postoperative pain (Eccleston, 2011). Despite clinical research and initiation of regulatory standards, postoperative pain management is still inadequate due to a variety of factors including diverse pharmacological options, negative attitudes towards opioids, and inadequate staff education (Grinstein-Cohen, Sarid, Attar, Pilpel, & Elhayany, 2009). Research findings indicate that adequate postoperative pain management occurs in only 25% of surgical patients (Wu & Raja, 2011). Inadequate pain control directly relates to increased lengths of stay and postoperative complications. For instance, Frost and Sullivan Company (2011) found an increased length of stay by greater than one day due to improper pain management. This increase becomes an issue when inpatient hospitalization averages $1,629 per day in the United States, not including procedures, testing, or medications (Oh, 2012). Inadequate pain control leads to tachycardia, hypertension, immunosuppression, and hyperglycemia. These may result in delayed healing and the risk of readmissions within 30 days, which can also result in increased overall hospital costs (Wu & Raja, 2011). The emotional distress of pain on both the patient and family further complicates healing by affecting behaviors and decisions (Linton & Shaw, 2011).

Significant pain experienced in hospitalized patients can delay the patient’s healing process and increase the risk of developing chronic pain (Slatyer, Williams & Michael, 2015). The primary focus of nursing is to provide quality patient care which includes pain management. Although great strides have been accomplish in the science of pain management, patient often report the experience of moderate to severe pain that was not adequately controlled during their hospital stay (Bernhofer & Sorrell, 2015). Nurses sometimes find it challenging when caring for patients with pain and are unsuccessful in providing optimal relief which may lead to a feeling of moral distress in the nurse (Bernhofer & Sorrell, 2015). Nurses’ ability to understand patient’s pain and provide effective management while, using and effective coping mechanism is a phenomena of great importance.

Uncontrolled pain can have a major impact on a patient’s quality of life and the ability to obtain successful operative outcome. (Crisp et. al 2012) The importance of pain management in postoperative care is emphasised in this essay, to provide the understanding that effective postoperative care includes providing the patients with maximum comfort, satisfaction and encourage the healing process for early discharge from hospital. Inadequate pain control in postoperative care can also enable the patient to feel hopelessness, develop depression and other effects that can lead to detrimental consequences. (Human Rights Watch 2009) Therefore, the effects of uncontrolled pain is also discussed in this essay, to highlight the significance of appropriate

This article notes that the American Pain Society (APS) Satisfaction Survey and the variations of the APS survey utilized to assess patient satisfaction do not necessarily correlated to adequate pain management. Through a detailed analysis of an adapted APS survey from 787 post-operative patients, the researchers determined a correlation coefficient (r) of -0.24 between pain intensity and satisfaction, indicating a negative relationship between the two

Chen C, Mehta SS (2008) studied about the Postoperative experience: results from a national survey suggest postoperative pain continues to be undermanaged. Approximately 80% of patients experienced acute pain after surgery. Of these patients, 86% had moderate, severe, or extreme pain, with more patients experiencing pain after discharge than before discharge. A survey of 250 US adults who had undergone a recent surgical procedure asked about their postoperative pain experience. Approximately 80% of patients experienced pain after surgery. Of these patients, 86% had moderate,

For patients, there are many safe options to help with pain and the process of healing. Users can choose between a number of pain therapy options that fits their needs. When choosing an item to help with pain management, users should consider these things...

According to many experts in the field, one reason that patients continue to needlessly suffer from improper pain management is the lack of expertise of nurses and physicians. Many health care professionals lack the proper knowledge and attitude for effectively managing pain, leaving many patients to endure a reduced quality of life. This lack of

I read the article by Chou et al. (2016), and I think it is commendable how the panel was selected to review the evidence and provide recommendations for postoperative pain (Chou et al., 2016, p. 132). In the article, the panel was composed of professionals with expertise from anesthesia, pain medicine, surgery, obstetrics and gynecology, pediatrics, hospital medicine, nursing, primary care, physical therapy and psychology (Chou et al., 2016, p. 132). Additionally, I agree with their first recommendation that clinicians should provide an individualized education regarding postoperative pain management that is patient and family-centered (Chou et al., 2016, p. 133). When I previously worked in Med-Surg, there were particular instances when I

Introduction: Recent estimates indicate that millions of major surgical procedures are performed worldwide each year and Patients undergoing gastrointestinal surgery for malignancy are typical representatives of such high-risk patients. [1] Major abdominal surgeries induce neurohumoral changes responsible for postoperative pain, various organ dysfunctions and prolonged hospitalization. Inadequate pain control is harmful and costly thus an appropriate pain therapy must be used to those patients. [2] Bakr et al.