Pain: A quality of care issue during patients' admission to hospital

Carr, Eloise; Meredith, Paul; Chumbley, Gillian; Killen, Roger; Prytherch, David; Smith, Gary B.

doi:10.1111/jan.12301

Cited by 38 publications

(43 citation statements)

References 55 publications

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“…A previous study supported this finding described that a pain management standard is effective for improving the quality of pain reduction, while an absence of standard results in inadequate pain management. [31] Similar findings have been found in previous studies in trauma. [3,20,21] This present study found that the hospitalized trauma patients rated moderate to high levels of satisfaction with the pain management strategies implemented by both the physicians and the nurses when they had pain at mild to moderate level during three days after admission.…”

Section: Discussionsupporting

confidence: 82%

Pain experience, pain management strategies and satisfaction of hospitalized trauma patients in Indonesia

Prastika

Kitrungrote

Damkliang

2017

JNEP

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Although trauma is a common cause of greater pain and interference on daily activities, little is known about pain experience, pain management strategies and pain management outcomes in hospitalized trauma patients in Indonesia. This descriptive study aimed (1) to assess the pain experience, (2) to describe pain management strategies, and (3) to describe satisfaction with pain management conducted by healthcare providers as perceived by trauma patients. A total of 154 hospitalized trauma patients from a teaching hospital in Indonesia were recruited from January to March 2016. Data were analyzed using descriptive and inferential statistics. The study found that most of the hospitalized trauma patients had single extremity fractures (56.49%) and mild head injury (20.13%). They have experienced a mild to moderate level of pain intensity and pain interference during the first three days of admission. These pain intensity and pain interference levels were found to be significantly decreased from the first to the third day. The pain management strategies often used by the healthcare providers were showing interest and asking about pain, assessing the outcomes after receiving analgesic drugs, and giving information about pain. The pain management strategies often used by patients were praying (86.36%), slow and deep breathing (77.27%), and reciting Dzikir (meditation) (68.18%). Patients reported that performing Dzikir and praying were the effective strategies to reduce their pain. The patients rated moderate to high levels of satisfaction with pain management conducted by healthcare providers. Therefore, combinations analgesic drugs with praying and performing Dzikir related to cultural contexts are crucial to alleviate pain among hospitalized trauma patients in Indonesia.

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Section: Discussionsupporting

confidence: 82%

Pain experience, pain management strategies and satisfaction of hospitalized trauma patients in Indonesia

Prastika

Kitrungrote

Damkliang

2017

JNEP

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“…pain ratings), this is possible without the need for healthcare professionals to ask patients to complete a lengthy questionnaire. However, pain is shown to be requested and recorded at specific times and not tailored to patients’ needs (Carr et al., ). This implies that in addition to asking about pain intensity at regular intervals, pain assessments must be performed more frequently following breakthrough pain.…”

Section: Discussionmentioning

confidence: 99%

“…Carr et al. () consider pain assessments as a patient safety issue since high pain intensity after surgery may cause chronic pain. Although there can be difficulties in obtaining pain ratings, there are numerous benefits to optimizing pain assessments and documenting them.…”

Section: Discussionmentioning

confidence: 99%

Association of pain ratings with the prediction of early physical recovery after general and orthopaedic surgery—A quantitative study with repeated measures

Eriksson

Wikström

Fridlund

et al. 2017

Journal of Advanced Nursing

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“…A number of studies internationally have identified that pain is often substantially undertreated or untreated in geriatric patients (Daoust et al, 2014, Lukas et al, 2013, Morrison and Siu, 2000, Niruban et al, 2010, and that people with dementia are significantly less likely to receive analgesia than their cognitively intact counterparts (Closs et al, 2004, Hoffman et al, 2014, Morrison and Siu, 2000. There are particular issues with the management of pain for older patients in acute hospital settings (Atkinson and Almahdi, 2014, Carr et al, 2014, Chang et al, 2010, Lin et al, 2014, Niruban et al, 2010. Poor management of pain may lead to slower rehabilitation and a decrease in physical function with hospitals stays longer for a person with dementia than for others admitted for the same procedure (Alzheimer's Society,…”

Section: Introductionmentioning

confidence: 99%

Using sense-making theory to aid understanding of the recognition, assessment and management of pain in patients with dementia in acute hospital settings

Dowding

Lichtner

Allcock

et al. 2016

International Journal of Nursing Studies

118

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Background: The recognition, assessment and management of pain in hospital settings is suboptimal, and is a particular challenge in patients with dementia. The existing process guiding pain assessment and management in clinical settings is based on the assumption that nurses follow a sequential linear approach to decision making. In this paper we re-evaluate this theoretical assumption drawing on findings from a study of pain recognition, assessment and management in patients with dementia. Aim:To provide a revised conceptual model of pain recognition, assessment and management based on sense-making theories of decision making. Methods:The research we refer to is an exploratory ethnographic study using nested case sites. Patients with dementia (n= 31) were the unit of data collection, nested in 11 wards (vascular, continuing care, stroke rehabilitation, orthopaedic, acute medicine, care of the elderly, elective and emergency surgery), located in four NHS hospital organizations in the UK. Data consisted of observations of patients at bedside (170 hours in total); observations of the context of care; audits of patient hospital records; documentary analysis of artefacts; semi-structured interviews (n=56) and informal open conversations with staff and carers (family members).Findings: Existing conceptualizations of pain recognition, assessment and management do not fully explain how the decision process occurs in clinical practice. Our research indicates that pain recognition, assessment and management is not an individual cognitive activity; 2 rather it is carried out by groups of individuals over time and within a specific organizational culture or climate, which influences both health care professional and patient behavior. Conclusions:We propose a revised theoretical model of decision making related to pain assessment and management for patients with dementia based on theories of sense-making, which is reflective of the reality of clinical decision making in acute hospital wards. The revised model recognizes the salience of individual cognition as well as acknowledging that decisions are constructed through social interaction and organizational context. The model will be used in further research to develop decision support interventions to assist with the assessment and management of patients with dementia in acute hospital settings.

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Pain: A quality of care issue during patients' admission to hospital

Cited by 38 publications

References 55 publications

Pain experience, pain management strategies and satisfaction of hospitalized trauma patients in Indonesia

Pain experience, pain management strategies and satisfaction of hospitalized trauma patients in Indonesia

Association of pain ratings with the prediction of early physical recovery after general and orthopaedic surgery—A quantitative study with repeated measures

Using sense-making theory to aid understanding of the recognition, assessment and management of pain in patients with dementia in acute hospital settings

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