PCA pumps are programmable opioid pain management devices for self delivery of pain medication. The theory was designed based on the research that if patients had more efficacy in post-operative pain management of pain medication, this would reduce adverse effect and increase better patient satisfaction.
Objective
Evaluation of the effectiveness and safety of PCA nurse given opioids as per needed pain medication for post operative pain control as a better patient outcome and improvement of nursing intervention
Data collection/Analysis
This was a meta-analysis evaluating the outcome on the patient satisfaction survey scores, the amount of intake of medication vs PCA usage, adverse effects and the visual analog scale which is a numerical pain rating system measured characteristics of a person experiencing pain. Data collected from Cochrane Central Register for controlled trials, Medline and Embase by authors extracted data from randomized controlled trials. RCT’s are the high quality trials for defining the relationship between the cause and effect which can provide the development of effective quality evidence based practice for the best patient outcome when performing nursing interventions.
Results
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The primary result subjects using PCA had a lower vas with a 95% confidence interval. The secondary result subjects were more satisfied with the PCA
In medical school/pharmacology school, medical professionals are taught to treat severe pain with opioids. However, opioids should be prescribed with the possibility of future dependency in mind. Physicians often struggle with whether they should prescribe opioids or seek alternative methodologies. This ethical impasse has led may medical professionals to prescribe opioids out of sympathy, without regard for the possibility of addiction (Clarke). As previously stated, a way to address this is use alternative methods so that physicians will become more acquainted to not not treating pain by means of opioid
Physical pain is more easily addressed by the administration of medication or a non-pharmaceutical intervention like repositioning, or the application of heat or cold. Nursing care on a general medical unit is about patient and family centered care which is in alignment with Kolcaba’s Theory of Comfort. A large portion of the patients seen on this type of unit have multiple comorbidities and challenging social situations that require assessment of their past health history, their support system, and their current living situation. All of this is taken into consideration in multidisciplinary rounds where data that is collected is communicated to all disciplines and a plan of care developed for each patient. The unit which I currently manage assembles our multidisciplinary unit daily. Needs are identified and assigned to the team members who include social work, care management and therapies in addition to the nurses and the providers. Since the team meets daily there is an opportunity to evaluate the effectiveness of the interventions prescribed. Nursing care management is integral in this work as part of the assessment, planning, and coordination of care in the hospital
Patients often have complex care needs, and often present with multiple co-morbidities or problems. The process of conducting a comprehensive nursing assessment, and the coordination of care based on these findings is central to the role of the Registered Nurse (NMBA 2006). Evidence-based interventions must then be planned and implemented in a patient-centred approach in order to achieve agreed treatment goals and optimise health (Brown & Edwards 2012).
Implications for nursing practice are as follows. First, the study indicated that additional medical intervention is not always supportive of positive patient outcomes. Instead, it
...tive pain management and Improvement in patients outcomes and satisfaction [Magazine]. Critical Care Nurse, 35(3), 37,35,42. Retrieved from
Assessing and managing pain is an inevitable part of nursing and the care of patients. Incomplete relief of pain remains prevalent despite years of research due to barriers such as lack of kn...
Nurses have the opportunity to play a pivotal role in addressing perineal pain by assessing lacerations, assessing pain levels and providing pharmacological and non-pharmacological pain relief methods. The most common non-pharmacological
Chung, Y., Tsou, M., Chen, H., Lin, J., & Yeh, M. (2014). Integrative acupoint stimulation to alleviate postoperative pain and morphine-related side effects: A sham-controlled study. International Journal of Nursing Studies, 51(3), 370-378. doi:10.1016/j.ijnurstu.2013.06.007
Opioids are a class of drugs which have been used since ancient times to reduce pain.
To provide the best care for their elderly patients, nurses must incorporate pain assessment into their daily care of patients. Pain assessment is a key aspect of the nurse’s role. There are many factors to consider when assessing patients’ pain such as if they are verbal or non-verbal, what language they speak, their age and their cultural background. There are many tools that a nurse can use to assess a patient’s pain but one of the most common tools is the 0-10 scale. This tool can be asked verbally by asking what their pain level is on a scale of 0 to 10 with 0 being no pain and 10 being the worst pain they have ever had. You may also use this tool in a visual manner with faces that correlate to the numbers. 0 being a happy face and 10 being a very sad face. Elderly patients from diverse cultural backgrounds are increasing in long term care facilities so it is important to have a 0 – 10 pain scale written in their native language. Some patients are stoic and do not express their pain as much as other people so it is important to understand that a 0 – 10 pain scale might not always be sufficient and could be combined with observing any physical signs that the patient might be in pain such as facial expressions and guarding. Nurses must have a good base of knowledge and attitude towards pain and always take what the patient reports their pain scale to be as truth. If the patient does report pain it would be important to treat the pain or if it is a new occurrence to follow this assessment up with another val...
In addition, to keep a patient comfortable, pain control promotes recovery and may reduce risk of developing certain complications after surgery. Through the use of guided imagery and other pain management strategies, the patients can achieve better pain control and improved functioning and will enjoy a better quality of life (Dobson & Byrne, 2014). Also, the inability to escape from pain may create a sense of helplessness and even hopelessness, which may predispose the patient to a more chronic depression. According to Wells, Pasero, and McCarffery (2008), around the clock dosing is recommended during this early post-surgical period to prevent severe pain and control continuous pain.
Findings. Pain has many different meanings to many people. What is important to know as a nurse or health care provider is that pain is what the patient says it is. It is not the nurse or provider’s place to determine what the patient’s pain is but rather take an in-depth history and assessment. Using this assessment and history can therefore help treat your patient’s pain accordingly. Also pain theories have been proposed and used the implications of nursing practice in regard to pain.
Opiods are the most popular class of drugs used for post-cesarean analgesia. They are most useful in treatment of somatic pain. Use of morphine, diamorphine, fentanyl, sufentanil, meperidine, nalbuphine and buprenorphine is well documented. The various opiods differ in their potency and severity of side effects. A discussion of the merits and de-merits of each is beyond the scope of this article. The common minor side effects include nausea, vomiting, pruritus, shivering and urinary retention. Respiratory depression, especially late-onset, is a more dreaded complication.
The major concepts deduced from the hypothesis fall under three categories: (1) multimodal intervention, (2) attentive care, and (3) patient participation. Multimodal intervention includes the concepts of potent pain medication, pharmacological adjuvants, and non-pharmacological adjuvants. Attentive care relates to the assessment of pain and side effects and intervention along with reassessments. Patient participation includes goal setting and patient education. The resulting outcome of these three categories working together is the balance between analgesia and side effects.
In the context of the caring relationship, nurses perform a primary role in the assessment and management of pain and other