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Nursing fundamentals quizlet on concept of holistic nursing
Pain management process
Kolcaba / comfort theory
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Introduction
Between 1900 and 1930, comfort was the goal of both nursing and medicine. Since then, comfort has increasingly been a minor focus, only for those with no other medical treatment options available (March & McCormack, 2009). Pain management is a very important part of patient care, however, it can be overlooked, ill-managed, or not treated effectively. Nurses and healthcare workers can let their personal beliefs and values get in the way of how they treat their patients with pain medications. The Quality and Safety Education for Nurses (QSEN) has addressed pain management in their patient-centered care competency. It addresses the knowledge, skills and attitudes that a nurse should have to care for a patient's pain. This paper will use Kolcaba's Comfort Theory as a foundation to provide management of pain for patient's while hospitalized.
Review of the Research Literature
Identified Nursing Theory and Nursing Practice Focused Problem
Katherine Kolcaba developed her Comfort Theory in the 1990s. She describes comfort in three forms: relief, ease and transcendence, and believes that comfort nurtures and strengthens patients (March & McCormack, 2009). If the comfort needs of a patient are met, for example, if they are experiencing pain, and pain medications are administered, the patient experiences relief. When a patient is comfortable and content, for example when stressful situations are addressed and removed, they experience ease. Transcendence is achieved when a patient is able to rise above their challenges, as in when a patient is involved in physical therapy.
Comfort can be described in four contexts: physical, psycho-spiritual, environmental, and sociocultural (March & McCormack, 2009). The physical portion of...
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...hcare: modifying Kolcaba's comfort theory as an institution-wide approach. Holistic Nursing Practice, 23(2), 75-82. doi:10.1097/HNP.0b013e3181a1105b
McCullers Varner, J. (2012). Safe and Effective Pain Management in Elders. Alabama Nurse, 39(2), 11-14.
Oware-Gyekye, F. (2008). Pain management: the role of the nurse. West African Journal Of Nursing, 19(1), 50-54.
Rose, L., Haslam, L., Knechtel, L., McGillion, M., & Dale, C. (2013). BEHAVIORAL PAIN ASSESSMENT TOOL FOR CRITICALLY ILL ADULTS UNABLE TO SELF-REPORT PAIN. American Journal Of Critical Care, 22(3), 246-255. doi:10.4037/ajcc2013200
Wadensten, B., Fröjd, C., Swenne, C., Gordh, T., & Gunningberg, L. (2011). Why is pain still not being assessed adequately? Results of a pain prevalence study in a university hospital in sweden. Journal Of Clinical Nursing, 20(5/6), 624-634. doi:10.1111/j.1365-2702.2010.03482.x
Pain is not always curable but effects the life of millions of people. This essay examines the Essence of Care 2010: Benchmarks for the Prevention and Management of Pain (DH, 2010). Particularly reflecting on a practical working knowledge of its implementation and its relevance to nursing practice. It is part of the wider ranging Essence of Care policy, that includes all the latest benchmarks developed since it was first launched in 2001.
Family centred care and comfort care theory both work for the well being of patient. Family centred care focus to work with family while providing care for the sick child. Family and pediatric staff works in collaboration to make care plan that works the best for sick child (Coyne, O'Neill, Murphy, & Costello, 2011). Similarly, comfort care theory focus on child’s physical, psychospiritual, sociocultural, and environmental aspects. “When comfort needs are addressed in one context, total comfort is enhanced in the remaining context” (Kolcaba & Dimarco, 2005, p. 190). When nurses apply comfort care theory, it is to achieve holistic care of sick children by focusing on all aspects (Kolcaba
Of seventy-eight emergency department nurses who completed the education program, the post-test scores have significantly increased by 12.6 % than the pre-test. The majority of the participants, about 88%, reported that the program went effectively and feel the confidence of assessing the pain with the pediatric patients. In addition, the author reviewed 60 patients’ EMR for two weeks after the nurses have completed the education program for demographics means and nurse’s pain-related documentations. Although the majority of patients (87%, n=52) had documentation of pain assessment at triage, only 32% (n=11) of the patients got pharmacological or non-pharmacological interventions for pain. Also, below 30% of had documentation of the characteristics of pain quality, onset, and progression. Pain assessment scales are well used after completing education program, but the characteristics of pain represented the lowest protocol adherence. The nurses in this project demonstrated an increase in knowledge and comfort level in assessing pediatric pain assessment when the EMR reviewed, the majority of the participants' adherence to use of correct pain scale and pain assessment at triage, but nonadherence to document the characteristic of pain and post-intervention have found.
Stein, W. M 2001. Pain management in the elderly: pain in the nursing home. Clinics in Geriatric Medicine, 17, 575-594.
on Pain Care will evaluate the adequacy of pain assessment, treatment, and management; identify and
In the medical profession, personnel are asked to make judgments or draw conclusions based on measureable results. Physical assessments, vitals, CT scan, MRI, biopsy are all activities engaged in to prove abnormalities and make decisions as to the way forward. So having hunches are not considered reliable and rightly so. To decide to give a particular medication because of a mere hunch can lead to serious errors. However, pain which is now considered a part of the vital signs is based on the patients’ philosophy or view point and we (nurses) are told not to ignore but respond. This is highly subjective. It’s viewed how the patient sees it and not as tangible or measurable as the other ways of proving when something is abnormal. The situation to be presented will disclose a patient’s ordeal due to a nurse’s approach to or understanding of pain management. It will also assess whether the nurse responded in accordance to protocol.
Nurse Molly, who is continuing the care in the Medical Surgical Unit noted that Toby-Finn and his brother, Toto are anxious. She initiated a therapeutic communication, and encouraged both of the patient and the brother to verbalize their feelings and concerns. Toby-Finn then stated that he is worried that the pain will never go away. Nurse Molly is aware that pain is an unpleasant sensory and emotional sensation associated with actual and potential tissue damage (Porth, 2011). To her best knowledge, Nurse Molly explained about acute and chronic pain.
This essay will aim to look at the main principles of cancer pain management on an acute medical ward in a hospital setting. My rational for choosing to look at this is to expend my knowledge of the chosen area. Within this pieces of work I will look to include physiological, psychological and sociological aspects of pain management.
The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety issues surrounding PCA use include infusion pump programing errors, basal infusion dosing, and proxy errors when using PCA by proxy (Ladak, Chan, Easty, & Chagpar, 2007). Therefore, the purpose of this report is to examine the benefits and risks of patient-controlled analgesia and how it relates to nursing practice.
The general idea of, K, is that a nurse must have knowledge in the diversity of cultures, ethics, and education. The significance of this faction being that if the nurse is cognizant of the patient 's culture, beliefs, family values, support systems, and education level, a more thorough and comprehensive plan of care can be formulated. The premise of, S, is that a nurse must be skilled in the ability to communicate with and advocate for the patient, assess for and properly treat pain, and incorporate the needs and concerns of the patient and their family. The significance of this group and development of these skills include the achievement of pain control, increased rehabilitation periods, and an increase in patient/family satisfaction. The theme of, A, requires that a nurse maintains an open attitude toward the patient and to respect and validate the nurse-patient relationship, which will aid in a positive nurse-patient
Pain and suffering is something that we all would like to never experience in life, but is something that is inevitable. “Why is there pain and suffering in the world?” is a question that haunts humanity. Mother Teresa once said that, “Suffering is a gift of God.” Nevertheless, we would all like to go without it. In the clinical setting, pain and suffering are two words that are used in conjunction. “The Wound Dresser,” by Walt Whitman and “The Nature of Suffering and Goals of Medicine,” by Eric J Cassel addresses the issue of pain and suffering in the individual, and how caregivers should care for those suffering.
...amount of pain) is a great teaching tool for the patient who is able to self-report (Nevius & D’Arcy, 2008). This will put the patient and nurse on the same level of understanding regarding the patient’s pain. The patient should also be aware of the added information included with the pain scale: quality, duration, and location of the pain. During patient teaching, it should be noted that obtaining a zero out of ten on the pain scale is not always attainable after a painful procedure. A realistic pain management goal can be set by the patient for his pain level each day.
Comfort is important to caring in nursing because it is the nurse 's job to try and help the patient feel at ease and be pain free.
In today’s health care, the primary focus is not just helping the patient get better or curing diseases; many health care organizations are starting to recognize the benefits and importance of providing patients a healing type of environment. A healing physical environment is one that provides patients’ safety and comfort. It also reminds the health care staff why they chose health care as their career (Eberst, 2008). A healing hospital is a healing culture that respects people’s traditions and values. A healing environment is comprised of providing patients’ a loving, safe, comfortable and compassionate environment that promotes healing. As stated by Laura Eberst, “True healing environments are constructed in ways that help patients and their families cope of the stresses of illness.”
Nursing behaviors that improve patient comfort are as simple as positioning and repositioning, knowing patients special comfort habits, and advocating for family presence (Kolcaba & DiMarco, 2005). It is important to use a measurement tool to assess comfort and remember to reassess for a positive outcome or plan a new intervention. Comfort is associated with the pursuit of healthy behavior, increased patient satisfaction, and better cost-benefit ratios (Kolcaba & DiMarco, 2005). Although Watson’s caring model is a broad philosophy that applies to nursing practice in general, nurses utilizing this theory would find Kolcaba’s middle-range comfort theory aligns well within the framework those