The diagnostic value of the numeric pain rating scale in older postoperative patients

MSc, RN Jacqueline Fm van Dijk; Kappen, Teus H.; Wijck, Albert Jm van; Kalkman, Cor J.; PhD, RN Marieke J Schuurmans

doi:10.1111/j.1365-2702.2012.04288.x

Cited by 47 publications

(36 citation statements)

References 22 publications

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“…Effective pain management of emergency department (ED) patients with bone fractures is not only a crucial element in patient satisfaction, but it is also a priority for providers and nurses because unrelieved pain can lead to adverse physical and psychological consequences (van Dijk, Kappen, van Wijck, Kalkman & Schuurmans, 2012). A seven year national survey published in the Annals of Emergency Medicine in 2012 concluded that patients 75 years or older who presented to EDs with a complaint of pain were 19% less likely to receive pain medication when compared to younger adults with similar injuries (Platts-Mills et all., 2012).…”

Section: Discussionmentioning

confidence: 99%

“…Assessing pain and encouraging patients to report pain is essential because unrelieved pain can lead to adverse physical and psychological consequences (van Dijk, Kappen, van Wijck, Kalkman, & Schuurmans, 2012). According to the geriatricpain.org website "Pain is always subjective.…”

Section: Pain Scalesmentioning

confidence: 99%

“…This tool has been found valid in several studies but is limited because it requires the patient to draw on paper or an electronic record (Williamson & Hoggart, 2005) (figure 1). The NRS tool has the assessor ask the patient to rate his/her pain on an 11 point scale, where 0 equates to no pain and 10 is the worst pain imaginable (van Dijk, Kappen, van Wijck, Kalkman, & Schuurmans, 2012). The VRS has patients use the descriptive adjectives of no pain, mild pain, moderate pain and severe pain.…”

Section: Pain Scalesmentioning

confidence: 99%

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Is There a Difference in Pain Management of Patients with Upper Extremity Injuries in Relation to Age?

Pappas

2015

Preprint

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<p>Timely and appropriate analgesia for the treatment of long bone fractures is a primary goal of Emergency Departments. Despite incentives from the Centers of Medicare and Medicaid and accreditation agencies studies have found the existence of pain management disparities. The purpose of this research study was to conduct a retrospective chart review to investigate if patients with an upper extremity long bone fracture received pain medication within 60 minutes of arrival to the ED and to identify if there was a difference in the pain management of patients, with identical injuries, by age. Katharine Kolcaba’s comfort theory was used to guide the implementation of this project. Pain medication was provided within 60 minutes in 63% of the participants aged 69 and under and 56% of those aged 70 and older. A larger disparity occurred between the groups being medicated appropriately according to the World Health Organization’s guidelines for pain management with 63% of participants aged 18-69 receiving the appropriate pain medication compared to 45 % of participants in the 70 and over age group. The APRN has the opportunity to educate the nurses and members of the interdisciplinary team through evidence based practice in the safe and effective methods for treating acute pain across the lifespan.</p>

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Section: Discussionmentioning

confidence: 99%

Section: Pain Scalesmentioning

confidence: 99%

Section: Pain Scalesmentioning

confidence: 99%

See 1 more Smart Citation

Is There a Difference in Pain Management of Patients with Upper Extremity Injuries in Relation to Age?

Pappas

2015

Preprint

View full text Add to dashboard Cite

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“…13-15 The NRS should not be used alone, particularly in advanced age when the ability to appropriately use the NRS decreases; rather a combination of scales such as the VDS with the NRS is recommended. 16-17 …”

Section: Step 3: Measure Pain Intensity Using a Valid Reliable And mentioning

confidence: 99%

“…One-third of older adults reported postoperative pain as “painful but bearable” with a NRS of 5/10, 17 while nearly 53% of older adults have reported bothersome pain. 18 Older adults may state, “I can stand the pain, it's not that bad,” then refuse pain medications.…”

Section: Step 4: Assess the Tolerability Of Painmentioning

confidence: 99%

Assessing pain in verbal older adults

Booker

Haedtke

2016

Nursing

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Six‐year trends in postoperative prescribing and use of multimodal analgesics following total hip and knee arthroplasty: A single‐site observational study of pain management

Khaw

Bucknall

Considine

et al. 2020

European Journal of Pain

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Background: Guidelines for acute postoperative pain management recommend administering analgesics in multimodal combination to facilitate synergistic benefit, reduce opioid requirements and decrease side-effects. However, limited observational research has examined the extent to which multimodal analgesics are prescribed and administered postoperatively following joint replacement. Methods: In this longitudinal study, we used three-point prevalence surveys to observe the 6-year trends in prescribing and use of multimodal analgesics on the orthopaedic wards of a single Australian private hospital. We collected baseline postoperative data from total hip and knee arthroplasty patients in May/June 2010 (Time 1, n = 86), and follow-up data at 1 year (Time 2, n = 199) and 5 years (Time 3, n = 188). During the follow-up, data on prescribing practices were presented to anaesthetists. Results: We found a statistically significant increase in the prescribing (p < 0.001) and use (p < 0.001) of multimodal analgesics over time. The use of multimodal analgesics was associated with lower rest pain (p = 0.027) and clinically significant reduction in interference with activities (p < 0.001) and sleep (p < 0.001). However, dynamic pain was high and rescue opioids were likely under-administered at all time points. Furthermore, while patients reported high levels of side-effects, use of adjuvant medications was low. Conclusions: We observed significant practice change in inpatient analgesic prescribing in favour of multimodal analgesia, in keeping with contemporary recommendations. Surveys, however, appeared to identify a clinical gap in the bedside assessment and management of breakthrough pain and medication side-effects, requiring additional targeted interventions. Significance: Evaluation of 6-year trends in a large Australian metropolitan private hospital indicated substantial growth in postoperative multimodal analgesic prescribing. In the context of growing global awareness concerning multimodal analgesia, findings suggested diffusion of best-evidence prescribing into clinical practice. Findings indicated the effects of postoperative multimodal analgesia in real-world 108 | KHAW et Al. How to cite this article: Khaw D, Bucknall T, Considine J, et al. Six-year trends in postoperative prescribing and use of multimodal analgesics following total hip and knee arthroplasty: A single-site observational study of pain management.

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The diagnostic value of the numeric pain rating scale in older postoperative patients

Abstract: Nurses should not rely solely on the NRS score in determining pain treatment; they need to communicate with older patients about their pain, the need for analgesics and eventual misconceptions about analgesics.

Cited by 47 publications

References 22 publications

Is There a Difference in Pain Management of Patients with Upper Extremity Injuries in Relation to Age?

Is There a Difference in Pain Management of Patients with Upper Extremity Injuries in Relation to Age?

Assessing pain in verbal older adults

Six‐year trends in postoperative prescribing and use of multimodal analgesics following total hip and knee arthroplasty: A single‐site observational study of pain management

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