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Based upon the patient's condition and assessed needs, the education and training provided to the patient include any of the following:
discussion of pain
the risk for pain
the importance of effective pain management
the pain assessment process,
methods for pain management
Pain control approaches are to be collaborated and interdisciplinary in nature and utilize input from all members of the health care team, particularly the patient and significant others.
Staff are oriented to pain assessment and managing pain.
The following treatment modalities are available for use at Community Hospital to assist patients with treatment of pain:
Pharmacologic: oral, injectable, transdermal, PCA
Implanted pain pumps or devices
Non-pharmacologic modalities: distraction techniques, repositioning, music therapy, hot and cold therapy
The presence of pain is assessed on admission to the hospital, at the initial clinic visit, post invasive procedure, with each RN assessment, and upon the patient's initial complaint of pain.
A history of obesity and/or sleep apnea increases the risk of enhanced sedative effects and should be noted.
RN's provide comprehensive patient pain assessment.
LPN's collect basic health data on patients contributing to the comprehensive patient pain assessment.
The RN or physician shall perform an initial assessment for acute pain and, if relevant, for chronic pain, on all patients admitted to the emergency area, inpatient, or outpatient departments as applicable.
Pain will be quantified using one of the following pain scales:
The numeric pain intensity scale (NPIS) is a subjective scale where the patient communicate their current level of pain. 0= no pain and 10=the most severe pain imaginable. In order to use this scale, the patient must be alert, oriented, and cognitively able to understand the rating scale.
The Wong-Baker Pain Scale is a subjective,graduated facial expressions of pain scale where the patient communicates their level of pain by pointing to the picture that most accurately describes their current level of pain. This scale is used for alert and oriented patients, such as pediatric, non-English speaking, or patients with limited communication/comprehension of the numerical scale. A happy face represents no pain, and a sad face with tears indicates the patient is experiencing severe pain.
The FLACC Pain Scale is an objective measure that can be used for the patient who is unable communicate. When using this scale it is important to obtain a history when possible, from the patient's caregiver or past medical records to obtain a baseline of usual behavior. It is essential to differentiate behavioral expressions of pain from otherwise normal behavior for the patient in a similar situation.
For pediatric patients the children's pain scale or the infant pain scale may be used.
A patient’s report of pain will be accepted and respected as the key indicator of the amount of pain he/she is experiencing.
A significant other may be asked to assign a pain scale rating when the patient is unable to respond.