Pain management nursing : official journal of the American Society of Pain Management Nurses
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Comparative Study
Pain assessment tool in the critically ill post-open heart surgery patient population.
Critical-care patients are at higher risk for untreated pain, because they are often unable to communicate owing to altered mental status, mechanical ventilation, and sedation. Pain that is persistent and untreated affects most body systems and results in development of complications chronic pain, and increased length of stay. This descriptive repeated-measures study compared three pain assessment tools in nonverbal critically ill patients in a cardiac postanesthesia care unit (n=24). ⋯ Both scales adequately capture pain in the nonverbal sedated critically ill patient based on assessment of patients' face, body movements, muscle tension, and respirations, with the NVPS also considering vital signs. Pictures depicting facial expressions for scoring purposes are helpful. Adequate education and understanding of use of the scales is critical for accurate assessment and subsequent interventions.
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Despite many advances in the pharmacologic treatment of pain, the issue of unresolved postoperative pain continues to plague patients and health care professionals. Little seems to be known about the reasons why nonpharmacologic methods are not more widely used, particularly as they are commonly low in cost, easy to use, and largely free of adverse side effects. ⋯ Results of the teaching pilot showed significant post-teaching changes in subjects' knowledge and attitudes about nonpharmacologic methods for pain management, high satisfaction with the nonpharmacologic methods they chose, and incrementally greater use of the nonpharmacologic methods over the course of the hospital stay. A randomized controlled trial of the study is now in the early planning stages in an effort to obtain generalizable results that will help solidify evidence of the impact of music, imagery, and slow-stroke massage on pain management and confirm the value of patient teaching as an important means of offering patients more options for managing their own pain.