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Effective pain assessment and management can remove the adverse psychological and physiological effects of unrelieved pain. Optimal management of the patient experiencing pain enhances healing and promotes both physical and psychological wellness. Patients need to be involved in all aspects of their care including pain management.
Unrelieved pain – A pain score that remains above the patient's identified pain goal, or that remains at 5 or above for 3 hours.
Acute pain- pain that subsides as tissue healing takes place (McCaffery & Beebe, 1989). Acute pain has a predictable end, is transient, and is often highly localized.
Chronic pain- pain that persists three months beyond the usual course of an acute disease or three months beyond a reasonable time for tissue damage to heal, or pain that is associated with a chronic pathologic process that causes continuous or recurrent pain (Bonica, 1990).
Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.
Physical dependence is a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.
Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug’s effects over time.
Healthcare professionals at Community Hospital respect the patient's right to pain management, and to be informed of all available and appropriate methods of pain relief along with possible positive and negative consequences.
Staff work with the patient/family to set, develop, and implement a plan to reach a goal for pain relief. The patient's preferences for methods used to manage pain are considered.
Pain control planning includes both pharmacologic and non-pharmacologic interventions.
Pain should be actively assessed and monitored.
A comprehensive initital pain assessment by an RN, consistent with the scope of care, treatment, and services, as well as the patient's condition, is provided.
Ongoing data collection and monitoring may be performed by an LPN who reports abnormal findings to the RN for a more comprehensive assessment.
Methods to assess pain are consistent with the patient's age, condition, and ability to understand.
Patients with pain are reassessed as necessary based on the plan of care or changes in condition, or upon patient's desire for care, treatment &/or services.