Abstract This paper first examines the improvement of pain management at WellStar Health System. The impact of the Joint Commission's standards on pain management is also explored. The paper also discusses tjr cultural factors that influence one's perception of pain, using Asians' reluctance to express pain in public as an example. The paper explores the topic of data collection to assess the quality of care in pain management. Lastly, this paper examines and describes the various assessment tools used for treatment of pain.
Table of Contents:
Data Collection: Pain Management
Process Improvement
Regulatory and Social Impact
- Agency Influence
- Social Influence
Data collection methods
Assessment Tools and Pain Management
Conclusion
References
Appendix A
From the Paper "The topic of pain management in the healthcare setting is an important one when placing patient care as the most important goal in hospital management. The importance of pain management has reached the attention of the Joint Commission, the Centers for Medicare and Medicaid Services, and state regulatory agencies. Other community stakeholders have a stake in this topic due to its importance in healthcare. Pain management from a regulatory and social point of view as well as a process improvement plan follows in the discussion. The data collection methodologies concerning pain management issues and the tools for audit provide the matrix for evaluation and the need for amending the change initiatives."
Abstract This paper discusses pain mechanisms pertaining to dental pain. It focuses on the most recent and relevant advances in pain research, specifically the neuroanatomical, neurochemical and genetic aspects of pain modulation mechanisms. The N-methyl-D-aspartate receptor is used to illustrate the model's plasticity and the ways in which pain modulation works. This paper also discusses other mechanisms relevant to dental pain.
From the Paper "With the present volume of research that has accrued, pain control may have to veer away from the "killing two birds with one stone" approach that is still in use today. The mere number of modulating mechanisms at work at the genetic, intracellular and neuroanatomical level suggests a shift towards more individualized and effective pain treatment using these mechanisms is in order. Pain control generally attempts to inhibit the propagation of nerve impulses. The mechanisms are numerous, from directly or indirectly inhibiting the firing of neurons propagating pain impulses, stopping the inflammatory cascade at discrete steps in the process to disabling neurons from firing altogether. These include anesthetics, as well as analgesics such as the opioids, non-opioids, some antidepressants, anxiolytics, anticonvulsants, muscle relaxants among others (Dewar 343). The targets receptors of the opioid analgesics mainly lie along the periaqueductal grey and substantia gelatinosa."
Abstract This paper discusses the idea that the pain threshold is different for men than women, with the assumption being that women are better able to withstand pain then are man based primarily on the pain associated with childbirth. The paper further notes that some more recent research suggests that the situation may actually be reversed and that women may feel pain more acutely than do men, with research showing as well that women feel pain more often in the course of a lifetime, that they experience pain in more parts of the body, and that they may feel pain for a longer duration than do men.
Abstract This paper is a literature review of a quantitative research study based on pain assessment of neonates and the corresponding practice of documenting findings of the pain assessment. The author's beliefs and findings were consistent with other research in the area that while the belief is strong in the need to follow recommended assessments and use prescribed assessments tools, the practice of documenting assessment findings is inconsistent - in other words, pain assessments may take place, but little documentation exists.
From the Paper "Infants experience pain more acutely than do adults (Reyes, 2003). This is a concept that has radically changed since the time when the medical profession was of the belief that infants did not experience pain at all due to nerve fibers that were yet to develop myelinated sheaths. Also changing, has been technology and nursing practices related to neonatal pain assessment. This paper will analyze the October, 2003 article: Nursing Assessment of Pain, published in the Journal of Perinatal and Neonatal Nursing (Reyes, 2003). The analysis presentation will follow class report review guidelines, focusing on why this study is important to the field of nursing."
Abstract This paper discusses pain management, particularly in sickle cell disease. The paper describes the way that effective pain management can not only reduce physical discomfort, but also promote quality of life. The paper then describes the challenges of managing pain in sickle cell diseases, where the pain is chronic, however also has acute episodes.
From the Paper "Lived Experience of Sickle Cell Disease and Health Promotion Introduction Effective pain management not only reduces physical discomfort but also promotes quality of life. Nurses have the ethical and professional duty of managing pain and enhancing quality of life for their patients. However, with sickle cell disease, since chronic pain is combined with episodes of acute pain, pain management becomes a real challenge (Tanyi, 2003). The research question underlying this literature review is: how can a patient's pain be adequately managed and their quality of life improved during a hospital stay? The phenomenon of interest in this paper is pain management and how it is the key for improving quality of life."
Abstract The paper discusses the concept that pain ridden Americans are taking the idea of pain management into their own hands. More specifically, the paper discusses the movie "Fear and Loathing in Las Vegas" and hos the movie demonstrates that if the American legal system and physicians would provide better healthcare in the area of pain management, many people suffering from pain would not be abusing illegal drugs.
From the Paper "Terry Gilliam's movie "Fear and Loathing in Las Vegas" deals with this bioethical issue of how a war torn country was coping with its pain. Throughout the movie, the audience is constantly bombarded with images and scenes of war. Clips from newsreels of Vietnam show up on the television and background radio noise. While driving to Las Vegas, a woman on the radio speaks about soldier's dying from illegal drug overdose. The circus they attend while in Vegas is likened to "what the whole hip world would be doing on a Saturday night if the Nazis had won the war. This was the sixth Reich," (Gilliam 1998). On one scene, Dr. Gonzo screams out "I just got back from Vietnam," (Gilliam 1998) while throwing up outside of a car, antagonizing a couple next to them in a taxi. Due to lack of physician orientated help, many soldiers and Americans turned to illegal substances. Dr. Gonzo and Hunter S. Thompson view these illegal substances as their "medication." They medicate themselves throughout the movie to ease the pain cause by the war and of failing to obtain the American Dream, "Learn to enjoy loosing."
Abstract This graduate level nursing paper examines the concept of pain as it relates to the nursing profession. First, the paper explores the philosophical notion of pain as a basic concept. Next, the paper delineates the concept as it is applied to the nursing profession in general, and as it appears in nursing theory. Last, the paper summarizes the categories of pain.
From the Paper "The Mayo Clinic states that pain is an an unpleasant sensory and emotional experience associated with the stimulation of specialized nerve endings that signal actual or potential tissue damage, or that ..."
Abstract This paper discusses what nursing related factors contribute to and impact on or affect pain management in the pediatric population. It discusses the nature of pain in this population group and the difficulty in treating it due to the fact that the child cannot communicate his/her pain to either parents or nurses. The paper suggests that a high level of competence is needed by nurses in this field.
From the Paper "Literature Review Introduction Achievement of effective pain management among the pediatric population can be virtually impossible because the child cannot communicate his/her pain to either parents or nurses (Polkki, 2003). A high level of competence will be required by nurses in this setting. The research question for this literature review is: what nursing related factors contribute to and impact on or affect pain management in the pediatric population? Polkki et al.'s (2003) research was directly concerning with factors that both promote and interfere with nurses using nonpharmacological methods of pain alleviation."
Abstract This paper examines the act of self-inflicted pain as an act of religious piety. The writer traces this expression starting with early Christians. Also considered are the ideas and beliefs behind this approach to religious observance. The author concludes that self-inflicted pain is an expression based on the need to separate the mind from the body, the pain serving to cleanse the soul from the evil or potential evil the body contains.
From the Paper "According to one of the leading researcher and writers on sacred pain, its history is a contradiction, as the concept of suffering and pain in the world has also led many to stray from faith, as they cannot believe in a God who would let so much pain exists in the world, without end, as the whole of human existence is marked by pain, both physical and emotional, and yet throughout history, there are countless examples of the infliction of pain to cleanse the soul, "Ascetics, mystics and martyrs have sought and applied pain--in rights of passage (ordeals) and other forms of initiation--in service of religious inquisitions (including trials by ordeal), execution of heretics and witches and others." (Glucklich 389) Absolution, in a place closer to God is the end, be it for yourself or the heretic. Glucklich also stresses that these examples of "sacred pain" are not limited to time or geography."
Abstract This paper looks at relaxation as a form of pain management. It explains that relaxation alternatives such as acupuncture assist the patient in their pain management with a focus on the mind, body and spirit. It also discusses the management of post operative pain. In the conclusion the paper shows that further research and knowledge about relaxation and its positive affects on patients is essential for the improvement of the health care system.
From the Paper "Relaxation is a concept in the medical field that is often considered with great importance. This is because in order for the body to heal relaxation must occur, allowing the body to be open to the healing treatments. Tension, fear and stress work in opposition to good health, while relaxation allows the muscles and organs to be receptive to the healing process."
Abstract This paper discusses the controversies surrounding the use of hypnosis for treating acute pain. The paper examines how hypnosis works on pain management and the variety of techniques used in the process.
Abstract This paper presents an overview of Sickle Cell disease, discussing major concerns associated with the disease including that of pain management. The paper reviews a number of studies about the management of sickle cell disease pain.
From the Paper "Sickle cell disease is common in the United States among African-Americans. Pain is a problem associated with sickle cell disease which occurs when blood vessels become clogged with sickle shaped red blood cells that are hard and sticky, preventing blood from flowing through the veins. A clogged blood vessel is called an occlusion and occlusions in blood vessels can..."
Abstract This paper explains that research findings reveal that gender differences in pain are a complex phenomenon involving multiple biological psychological and sociocultural factors. The author points out that recent research recognizes gender presents a consistent picture of gender differences in pain. The paper states that women display greater perceptual and neurophysiological responses to noxious stimuli.
From the Paper "Who has a higher tolerance for pain - males or females? Gender and pain tolerance has been an interesting field of study for psychologists. Research findings reveal that sex differences in pain are a complex phenomenon involving many variables. Fillingim (2003) points out that "pain is a complex experience sculpted by multiple biological, psychological, and sociocultural factors (p. 2). In recently years, researchers have recognized that gender is one of the variables that influences pain. Fillingim notes that literature on experimental pain presents a consistent picture of gender differences in pain. Women display greater perceptual and neurophysiological responses to noxious stimuli (p. 2)."
Abstract This paper discusses the pain associated with labor and delivery, known to be the most intense pain imaginable. By definition, nurses are the major caregivers during labor who are charged with delivering comfort to the perinatal patient. This paper reviews pharmaceutical and non-pharmaceutical modes of intervention as well as discusses implications for nursing based on each mode of intervention.
Abstract This is a community health related assessment concerning the issue of low back pain among nurses. After a review of the prevalence of the disorder, the paper includes a comprehensive assessment examining biophysical, psychological, physical, socio-cultural, behavioral and healthcare system implications related to the problem. A critical analysis and community nursing diagnosis is also provided.
From the Paper "According to the US Department of Health (Brown, 2003) every day approximately 9,000 healthcare workers become disabled through injury on the job. Worker's compensation claims for healthcare workers related to back injuries are approximately $1.7 billion (Goldsmith, 2001) based on an injury frequency of 1 in 10 work related back injuries ending up with an injured nurse. According to Hedge (n.d.), the rate of injury to nurses is approximately twice that for all industries combined. Approximately 12% of nurses leave the profession each year due to back pain and back related injuries (ANA President Barbara Blakeney, 2004 as cited in "ANA Launches," 2004)."
