Pain Assessment in Emergency Department of Teaching Hospital in Lalitpur

Abstract

Background: Proper pain assessment is directly related to proper pain management.The American pain society (APS) in 1996 instituted “the pain as the 5th vital sign”, in an effort to reduce the burden of underassessment and inadequate pain management. The objective of this study is to find out the practice of pain assessment and to make improvement.
 Methods: This was an observational study of pain assessment by the medical officer in emergency department (ED).Convenience sampling was done at three different shift in ED. All the data of pain assessment was taken and tabulated and analysed to know the practice of pain assessment. Standard as set at 80%. In first stage data collection was done for one month as per convenience. Following the observed finding, in the second stage intervention was done. After this in third stage re-data collection was done to see the improvement.
 Results: A total of 503 patients were enrolled in this study. Out of this 53% (n=265) were in first stage and 47% (n=238) in third stage of the study. In first stage of the study there was 7% (n=19) documentation of numerical rating scale (NRS) and PQRST (P-precipitating and palliating factor, Q-quality of pain, R-radiation, S-site of pain, T-timing of pain) was not documented. After intervention in third stage documentation of NRS was done in 70% (n=167) and documentation of PQRST were variable.
 Conclusions: The study revealed that existing practice of pain assessment in the emergency department is poor but after the intervention there was remarkable improvement in the pain assessment.

Acid Peptic Disease among Patients with Acute Abdomen Visiting the Department of Emergency Medicine in a Tertiary Care Centre

“… 7 Female predominance of 47 (54.02%) was seen as consistent with similar studies of 52.6% and 52%. 5 , 8…”

“…In a study among Nepalese patients, the prevalence was 48.60%. 5 Acute abdomen is a medical emergency that can occur at any time in a lifetime of human beings and can put a substantial economic burden on a country where acid peptic disease occupies the majority portion. 6 Relatively young and working age population was affected with a mean of 31.63±16.45 years, 21-40 years age group was the most affected age group, similar to the study done in other parts of the world.…”

“…7 Female predominance of 47 (54.02%) was seen as consistent with similar studies of 52.6% and 52%. 5,8 Acid peptic disease, a condition causing significant morbidity and mortality worldwide, manifests in various ways. Interestingly, around two-thirds of patients diagnosed with peptic ulcer disease remain asymptomatic.…”

Exploring the perspectives of health professionals in a rural district hospital in Achham, Nepal on the role of daily continuing medical education (CME)

“…1 It is valuable to learn the perspectives of health professionals about daily CME in rural hospitals of Nepal. 13…”

Original Research: Combating the Opioid Epidemic Through Nurse Use of Multimodal Analgesia: An Integrative Literature Review

“…Inadequately managed postoperative pain can worsen patient outcomes and lead to increased hospital readmissions and health care costs 1. In 1996, amid numerous reports of inadequately managed pain, the American Pain Society introduced the concept of “pain as the fifth vital sign,”2 which was soon widely promoted by organizations such as the Joint Commission3 and the U.S. Department of Veterans Affairs 4. While an emphasis on appropriate pain management was intended to improve patient care, there is some evidence that this has instead contributed to the overuse of opioids 5…”