Undertreatment of Acute Pain with Narcotics

McCaffery, Margo; Hart, Linda L.

doi:10.2307/3424175

Cited by 14 publications

(6 citation statements)

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“…Os instrumentos unidimensionais mais utilizados são a escala visual numérica, a escala visual analógica e a escala de categoria verbal. Para pacientes vítimas de trauma, é proposta a utilização do diagrama corporal e da escala numérica como instrumentos objetivos, devido à rapidez de aplicação e a possibilidade de avaliações contínuas do quadro álgico, a fim de padronizar a interpretação dos fenômenos dolorosos com aferições frequentes e a ação dos fármacos, além da documentação do processo e diminuição de lesões e frustrações irreversíveis para o paciente e toda equipe multidisciplinar 5,11,12 , o que vem de encontro com os dados obtidos no presente estudo. Outro fato desafiador para a equipe de enfermagem é o manuseio da dor, pois é a equipe de enfermagem que programa a terapia farmacológica prescrita, dessa forma, medicar o paciente implica em conhecer além das vias de administração dos fármacos e sua indicação, sua ação farmacológica, reações, posologia e interações medicamentosas, o que exige maior conhecimento da farmacologia desses fármacos 8 .…”

Section: Resultsunclassified

Percepção dos profissionais de enfermagem frente à identificação, quantificação e tratamento da dor em pacientes de uma unidade de terapia intensiva de trauma

Magalhães¹,

Mota²,

Saleh³

et al. 2011

Rev. dor

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Rev Dor. São Paulo, 2011 jul-set;12(3):221-25 RESUMO JUSTIFICATIVA E OBJETIVOS: O trauma tem importância no âmbito mundial por ser uma das principais causas de morte e invalidez. A dor aguda sempre acompanha os pacientes vítimas de trauma e os profissionais da saúde têm dificuldade em identificá-la e consequentemente controlá-la. O objetivo deste foi caracterizar a percepção e as dificuldades da equipe de enfermagem frente à identificação, quantificação e manuseio da dor dos pacientes vítimas de trauma e treiná-la para sua avaliação e adequado tratamento. cientes vítima de trauma. Foi aplicado um questionário com perguntas relacionadas à caracterização dos profissionais e a maneira pela qual eles identificam, quantificam e intervêm no tratamento da dor, antes e depois de um curso de capacitação dos profissionais, no qual foram ministradas aulas que abordavam os temas contidos no questionário. RESULTADOS: A maioria dos profissionais incluídos no estudo conhecia o conceito "dor o quinto sinal vital", os instrumentos para quantificar a dor, os medicamentos utilizados no tratamento e seus efeitos adversos, porém com treinamento, o conhecimento sobre a avaliação e tratamento da dor aumentou significativamente. CONCLUSÃO: A maioria dos profissionais de enfermagem tem conhecimento insuficiente sobre a identificação, quantificação e tratamento da dor. O treinamento propiciou a sua atualização, para atuar de forma mais adequada e eficiente no controle e alívio da dor. Descritores: Dor, Medição da dor, Traumatismo múlti-plo, Unidade de terapia intensiva. MÉTODO: SUMMARY BACKGROUND AND OBJECTIVES:Trauma is globally important for being one of the major causes of death and disability. Trauma is also followed by acute pain and health professionals have difficulties to identify and control it. This study aimed at characterizing nursing teams perceptions and difficulties to identify, quantify and manage pain of trauma patients and at training the nursing team to adequately evaluate and treat it. METHOD: Prospective and quantitative study involving 51 nursing professionals working in an intensive

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Section: Resultsunclassified

Percepção dos profissionais de enfermagem frente à identificação, quantificação e tratamento da dor em pacientes de uma unidade de terapia intensiva de trauma

Magalhães¹,

Mota²,

Saleh³

et al. 2011

Rev. dor

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“…There are many risks of misinterpretation in the pain communication between the patient and the nurse, based on different attitudes to pain and cultural or psychological differences in pain expression. Furthermore, the nurse's limited knowledge about the therapeutic dose of narcotic analgesics and the risk of adverse sideeffects (Marks and Sacher 1973), and lack of time to communicate with the patient (McCaffery 1976), might be disadvantageous.…”

Section: Risk Of Misinterpretationmentioning

confidence: 99%

Pain assessment by patients and nurses in the early phase of acute myocardial infarction

Bondestam

Hovgren

Johansson

et al. 1987

Journal of Advanced Nursing

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In 47 patients admitted to the coronary care unit (CCU) at Sahlgren's Hospital in Göteborg, Sweden, due to acute myocardial infarction (MI) the intensity of pain independently assessed by the patient and by the nurse on duty was evaluated during the first 24 hours in CCU. Pain was assessed according to a modified numerical rating scale graded from 0-10, where 0 meant no pain and 10 meant the most severe pain. A positive correlation between the patients' and nurses' assessments was found (r = 0.76; P less than 0.001). However, the nurses under-estimated the patients' pain in 23% of the situations and over-estimated it in 20%. Over-estimation was particularly found when heart rate and blood pressure increased. Many patients scoring their pain to fairly high degrees were not given pain-relieving treatment. Treatment with morphine did not cause substantial pain relief in a substantial number of patients. A significantly positive correlation was found between the patients' and nurses' assessments of pain, although under-estimation as well as over-estimation occurred. A few patients with severe pain were not treated and when treatment was given it was often ineffective.

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“…Pain management in the hospital represents a nursing‐sensitive outcome 23 . Research indicates a deficit in nursing awareness and treatment of pain 24 . Lack of nursing attention to and management of pain has been identified as an important predictor of patient satisfaction 25 .…”

Section: Literature Reviewmentioning

confidence: 99%

Patient Satisfaction in Ambulatory Surgery

Yellen

Davis²

2001

AORN Journal

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The purpose of this study was to explore the relationships between patient satisfaction and selected variables that were identified as important in ambulatory surgery. The study addressed whether the selected variables are associated with the satisfaction of patients admitted to the hospital for ambulatory surgery. A descriptive correlational study was conducted in two hospital settings with 130 ambulatory surgical patients. Nurses (n = 16) in the ambulatory surgery departments completed a nurse demographic data form. The patient sample differed between settings in age, diagnosis, and use of computers. The nurse sample differed in the number of nurses with computers in their homes and their satisfaction with nursing. Results showed that patients' higher ratings of postoperative pain correlated with higher patient satisfaction. Patients with high postoperative pain rated satisfaction with pain management lower. A point biserial correlation (rpb = .22) indicated a significant correlation between patient satisfaction and nurses' use of computers to collect and record patient information (P = .01). The patient sample in the setting where computers were used showed a higher mean patient satisfaction.

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Undertreatment of Acute Pain with Narcotics

Cited by 14 publications

References 0 publications

Percepção dos profissionais de enfermagem frente à identificação, quantificação e tratamento da dor em pacientes de uma unidade de terapia intensiva de trauma

Percepção dos profissionais de enfermagem frente à identificação, quantificação e tratamento da dor em pacientes de uma unidade de terapia intensiva de trauma

Pain assessment by patients and nurses in the early phase of acute myocardial infarction

Patient Satisfaction in Ambulatory Surgery

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