Bisidimo Hospital Pain Management
Policy and Procedures Manual
2011 EFY
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Purpose
Pain is considered as the 5th vital sign. A proper assessment of pain is
essential for successful management. Bisidimo Hospital recognizes a
patient’s right to pain relief and supports a multidisciplinary approach to
pain assessment and management. The purpose of this policy is to
establish standards for the assessment and management of pain.
Scope
This policy covers all personnel who provide care to patients in pain
management at Bisidimo Hospital.
Responsibility
Physicians, Nurses, patient care services staff, ancillary services personnel,
and other personnel involved in providing care to the patient are responsible
for following this policy.
Patient care/department managers or supervisors and clinical department
chairs are responsible for assuring their staffs are aware of the pain
guidelines and that they adhere to this policy.
Definitions
Pain: is an unpleasant sensory and emotional experience associated with
actual or potential tissue damage, or described in terms of such damage. Pain
is always subjective, however patients without the ability to communicate
may still experience pain. Pain has sensory, emotional, cognitive, spiritual,
and behavioral components that are interrelated with environmental,
developmental, socio-cultural, and contextual factors.
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Pain assessment: includes information from the patient/proxy about provoking
factors, quality/characteristics, region/radiation, relieving factors, associated
symptoms, timing, and pain scores obtained with a pain measurement tool.
When movement/activity causes or is expected to cause pain,
movement/activity pain scores are utilized.
Pain assessment/history: includes the information obtained from a pain
assessment, the history of pain and its management and a history of analgesic
use.
Pain screen: determines if pain is present or absent or if there is a recent
history of pain by utilizing verbal acknowledgment of pain by a
patient/proxy or utilizing a pain measurement tool.
Pain measurement tool: is a reliable, validated tool used to measure clinical
pain intensity and approved for use. Sample tools are attached to this policy.
Procedures
Nurse screens the patient for pain as part of the patient’s initial evaluation
and on an ongoing basis, if relevant to the visit.
Important consideration in pain assessment include: Pain is subjective and
two patients may report severity differently from each other; Despite the
fact that pain is specific to each person, patients can usually accurately and
reproducibly indicate the severity of their symptom by using a scale; Scales
enhance the ability of patients to communicate the severity of their pain to
health care professionals and the ability of clinicians to communicate
among themselves and Scales also allow the clinician to assess the effect of
medications;
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The nurse, physician or physician’s assistant obtains a pain
assessment/history when pain is present upon initial screening or upon the
first report of pain, whichever comes first. If the initial pain screen is
negative, but a later screen is positive and relevant to the visit, a pain
assessment/history is obtained by the nurse or the physician at that time.
Pain measurement tools utilized are consistent with the patient’s
developmental and intellectual capacity. Patient self-report is utilized
whenever possible.
Patients receive prompt, effective management of their pain and any
analgesic side effects if relevant to the visit.
Pain management plans are individualized and include consideration of
clinical condition, developmental, social, religious, and cultural concerns of
the patient/family/proxy.
Pain is reassessed with new reports of pain, with procedures or activities
that are expected to cause pain, and at appropriate intervals (ie., at time of
peak analgesic effect) to evaluate the effectiveness of pain management
interventions).
Reassessment after pharmacologic intervention includes assessing for the
presence of analgesic side effects. Pre and post-analgesic pain scores are
documented in the Medical Record.
Patients are educated about pain and its management including the patient’s
right to adequate pain management; the importance of pain management;
the patient’s and family’s/proxy’s role in pain assessment and management;
pain management options/plan and limitations, when appropriate; possible
side effects; and information to reduce barriers to effective pain
management.
When patients are moved to a different level of care or care site, continuing
pain issues are addressed and the pain management plan is communicated;
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Documentation
All pain management related documents and formats shall be included in
patient records;
This shall be ensured by assigned Nurses.
Staff Orientation and Training
Pain management orientations shall be given for staff as refreshment and
induction trainings;
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PAIN SCALES
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PAIN ASSESSMENT TOOL
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