Nursing Assessment of Wound-Related Pain: An Italian Learning Survey

Abstract

BACKGROUND Pain is an important symptom in wound management, and the choice of treatment directly affects the patient's quality of life. Pain assessment (PA) is essential for quality wound care and, in Italy, mandatory by law. OBJECTIVE To administer a dedicated learning survey to obtain a better sense of current PA practices, ensure more training, improve procedures, and reduce malpractice. METHODS A 16-month learning survey of nurses based on a validated questionnaire developed for this project. RESULTS The survey sample comprised 512 questionnaires. Of respondents, 78% were female, 56.1% were older than 40 years, 94% were RNs, and 6% were wound care specialist nurses. Participants performed a range of dressing changes per week (1-5, 46.3%; 6-20, 34.4%; >21, 19.3%). Although 93% of respondents considered PA important, only 26% recognized it as a vital parameter, and barely one-quarter (25.4%) were aware of current legislation mandating PA. The majority (95.3%) believed that PA is not consistent with pain perceived by the patient. Further, 87.3% stated that they did not have adequate knowledge to conduct a PA, 91.4% did not consider themselves up-to-date on PA, and 81% did not document PA results. However, specific wound care training leads to significantly better PA (P < .001): 71.9% of wound care specialist nurses recognized pain as a vital parameter, and 59.4% were aware of current legislation regarding PA; further, 81.3% consistently evaluated pain, 59.4% documented PA results, and 50% communicated the outcome to the physician in charge. CONCLUSIONS The results illustrate the lack of sensitivity, training, and education that Italian RNs have regarding PA in wound care.

Assessment of Wound-Related Pain Experiences of Patients With Chronic Wounds

“…23 Among 512 Italian wound care nurses, 93% (476/512) considered that wound PA was important. However, only 26% (133/512) recognized it as a vital parameter, and a quarter of the nurses (25.4%, 130/512) were aware there was current legislation mandating wound PA. 24 In addition, 87.3% (447/512) of the nurse participants stated that they did not have adequate knowledge to conduct wound PA; 91.4% (468/512) did not consider themselves to be up-todate regarding wound PA; and 81.1% (415/512) did not document wound PA results. 24 Thus, in order to manage WRP more effectively, we strongly recommend additional education of wound care nurses related to its management, including targeted interventions for alleviating pain based on its causes and severity.…”

Penerapan Teknologi Virtual Reality terhadap Perilaku Nyeri Pasien Pasca Bedah ORIF Fraktur Ekstremitas Bawah Saat Penggantian Balutan Luka

“…Analgesik merupakan lini pertama yang direkomendasikan untuk mereduksi nyeri, tetapi efek dan tingkat keamanannya berbeda-beda pada tiap individu. Penggunaan analgesik juga sering menimbulkan efek samping seperti gangguan pada gastrointestinal, depresi sistem pernapasan, ketergantungan secara fisik dan mental, dan lain-lain (Gethin et al, 2020;Toma et al, 2020). Oleh karena itu, terdapat kebutuhan dalam praktik klinis terkait penggunaan intervensi non farmakologis untuk manajemen tata laksana nyeri yang lebih baik dalam penggantian balutan luka (Fiala et al, 2018).…”

The effects of virtual reality technology on reducing pain in wound care: A meta‐analysis and systematic review

“…In clinical nursing, patients feel more pain when removing or changing dressings, cleaning wounds, removing necrotic tissue compared to other nursing care practice. Analgesics are the first‐line recommendations for the treatment of pain, but the effects and safety vary from person to person, and analgesics use often lead to side effects such as gastrointestinal reactions, respiratory depression, physical and mental dependence, etc 4,5 . Therefore, there is an urgent need in clinical practice using additional non‐pharmacological interventions for better pain management in wound care.…”