Healthcare: Post Operative Pain Assessment - Essay Example

Post Operative Pain Assessment Introduction This paper aims to discuss the post-operative pain assessment.The subject is highly significant because patients experience unnecessary pain or distress in the post-operative period which can lead to potential complications. However, if the medical professionals effectively apply the pain management strategies then patients can recover early and the probability of unnecessary pain can be reduced. This paper will help in understanding different phenomenon related to post-operative pain assessment such as the individual circumstances of patients and the fundamental communication techniques which are necessary to provide maximum comfort to patients (Mackintosh). The scale of the problem can be analyzed through a large number of clinical studies which have proved that patients often experience poor pain management and assessment by the medical professionals. Although the percentage of patients who complain about post-operative pain is low but the overall situation presents significant concerns. In the recent years medical professionals have tried to use technology based pain assessment techniques but the results do not show any significant improvement from patient’s perspective (Mackintosh). The paper is divided in different sections including tools, communication, training, patient education and recommendations. All of these will be discussed critically with the help of contemporary healthcare practices. Discussion Tools for Post-operative Pain Assessment There is a wide range of standardized post-operative pain assessment tools which are used by nurses. These can be distinguished in to two fundamental categories including uni-dimensional and multi-dimensional. Research indicates that multi-dimensional tools are rarely used in the post-operative pain assessment especially within the clinical setting. This is because they consume significant time while being highly complex in nature. Hence the most commonly used tools for pain management and assessment are uni-dimensional. The distinctive feature of these tools is that they focus on one or two major aspects of pain experienced by patients, for instance, they are usually used for reducing the pain intensity with respect to its location (Mackintosh). Fundamentally patients are required to mark the pain location on a body diagram which is then used by nurses. Despite of various benefits attached to the use of uni-dimensional pain assessment tools one must use them with precautions because they are specially targeted to reduce certain aspects of pain. Extensive precautions are also necessary because uni-dimensional pain assessment tools may generate results which are difficult to interpret. This is actually related to the fact that some patients face difficulty in pain conceptualizing or comprehending the numeric values given to the intensity of pain (Mackintosh). The difficulty in interpretation also occurs during the use of verbal rating scale, for instance, moderate pain is constituted by what aspects? Moreover, nurses often use such medical terms which are difficult to understand by the patients or these terms might be entirely unrelated to an individual’s case. On the other hand there are very few evidences which show the consistency between different reported ratings of pain. This can be better understood by an example that a patient might report that he/she is suffering from the seventh degree pain according to Numerical Rating Scale (NRS). Hence he has given analgesia by the nurse. Later when the performance and effectiveness of analgesia is reviewed then the same patient reports improvement in pain but the NRS shows the same degree of pain i.e. seventh (Mackintosh). In addition to this it has been observed that there is no consistency in the reported ratings of pain between different individuals while the ratings are also subject to difference of interpretations on the side of medical professionals. Here, it is important to acknowledge that uni-dimensional pain assessment tools significantly help in post-operative pain assessment despite of some interpretation issues. Thus their results are surely better than no assessment at all (Mackintosh). Communication Skills Communication skills have unmatched importance for medical professionals on the basis of the fact that they have to deal with diverse group of individuals who in most of the case do not have the fundamental medical knowledge. Good communication skills also help health care professionals in clear questioning with the patients while also preparing the medical documents which can be read and used by other medical professionals. Effective communication is actually an essential requirement for critically assessing the post-operative pain. Hence the health care practitioners are required to spend considerable time in communicating with patients. Here, they need to ensure that patients are comfortably reporting their pain while also the descriptions are made as per the individual condition of patients (Mackintosh). Some patients may act shy or may not be able to communicate freely due to gender, cultural or ethnic differences. Thus it is the responsibility of health care professionals to reduce or completely eliminate the communication barriers. Limitations in communication between patient and practitioner may also occur due to the difference of language or physical disabilities such as deafness. Research reveals that patients commonly do not report pain until it reaches to a state where it becomes unbearable. Sometimes this happens because patients perceive health care professionals very busy with other patients suffering from severe conditions and hence they do not want to create trouble for them (Mackintosh). When questioning patients about pain it is really important to ask about other conditions, for instance, physical or psychological aspects which might be accelerating pain. Some patients have undergone previous surgeries or intensive medical treatments which cause them severe issues in the post-operative period. Thus the health care professionals must prepare description about patient’s medical history prior to conducting the surgery. Here, all the aspects leading to potential post-operative pain should be assessed and managed separately (Mackintosh). This will actually help in interpretation of pain levels reported by patients while also analyzing the effectiveness of different tools and techniques which are used to reduce post-operative pain. In addition to this, following are the eight important factors which must be considered when communicating with patients (Mackintosh): 1. Intensity 2. Location 3. Kind of pain i.e. shooting, stabbing or throbbing 4. Variability or duration of pain 5. Particular terminologies used by patients to describe their pain experience 6. The most preferred technique or method of pain relief used by patients 7. Factors influencing pain 8. The overall impact of pain on patient. Training for Medical Professionals Health care practitioners are required to have training prior to conducting the post-operative pain assessment. This is important because understanding different aspects of pain while providing best available services to relief patient’s pain is the foremost duty of medical professionals. The training is actually delivered by the health care institutions with respect to the professional medical education of different applicants (Fenech). Although the training for post-operative pain assessment is given during the education period but practitioners must also avail training opportunities at different stages of their career. This will not only give them significant career advantage rather they will be able to use modern technology in pain assessment and management. Following are some major training lessons which are given to health care professionals (Fenech): Ethics: It is important for nurses and doctors to maintain a balance between compassion and practical approach while communicating with patients, attendants or fellow health care professionals. Medical ethics and the fundamental professional behavior have different aspects when it comes to post-operative pain assessment. For instance, Health care practitioners are required to be honest, responsible, understanding, organized, passionate and respectful towards patients while maintaining confidentiality. They have to respect other’s vision, values and religious beliefs. Dealing with patients can create significant privacy issues which must be dealt carefully whereas all the measures of modesty must be ensured. In addition to these, the case details of patients must not be shared on websites and social media without prior consent. Information: In the contemporary world it has become significantly easier to access information regarding wide range of subjects but the use and management of information is still an issue. Therefore medical professionals are required to have training in the area of information management. This will actually help them in analyzing different statistical data, using computer technology for generating information, collection, reporting and evaluation of medical literature. Moreover, training will facilitate medical professionals in effective use of online databases. Medical Education: Due to increasing number of diseases it is now important for health care practitioners to continuously gain medical education. This implies that they must receive trainings regarding the latest medical technology, cure of formerly untreatable diseases and overall patients’ care. A lifetime commitment with the medical education can provide immense benefits to the medical professionals both in terms of career and social service. Stress Management: Increasing exposure to patients’ problems and critical situations can make the job of health care professionals highly stressful. When it comes to post-operative pain assessment then stress management can become even more difficult. Hence practitioners must be given training in order to maintain good mental health while also performing their jobs productively. Patients Education Surgery is a painful and stressful experience for patients which can significantly impact their physical and psychological well being. Research indicates that if patients are given required education about the surgery itself and its possible outcomes in advance then it becomes significantly easier to assess post-operative pain. Furthermore, education reduces anxiety and helps in maintaining good relationship between practitioner and patient. In order to educate patients about pain anticipation pre-assessment is necessary which actually helps them in identifying and reporting pain (Corke). Here, the most important aspect is consultation one or two weeks before the surgery which not only helps patients in understanding the overall procedure rather it also helps practitioners in formulating the analgesic plan for an individual. During pre-operation consultation phase patients can comfortably discuss the pain assessment and management strategies. This might include persistent techniques such as peripheral nerve blocks, spinal opioids and epidural. Moreover, the tools particularly used for reporting pain can be described to patients such as the Numerical Rating Scale. Medical professionals can use simple and descriptive terminologies and diagrams for informing patients about different treatment procedures and their impact on body. Patient education also benefits in psychologically preparing individuals for surgeries. On the other hand if patients are well educated with respect to their particular cases then their post-operative stay at hospital becomes easier and shorter (Corke). Pre-operative patient education include different aspects such as recognizing pain, dealing with anxiety, fear of surgery, stress and psychological impacts depending upon the type of surgery, for instance, thoracic, abdominal, orthopaedic, etc. Other aspects include the age and weight of patient and duration of surgery. All of these are crucial factors which create difficulty in assessing the post-operative pain. Hence if they are identified earlier then it becomes convenient for health care professionals to formulate pain relief strategies as per patient’s individual circumstances. Patients suffering from significant psychological diseases such as depression are more in need of education prior to surgery (Corke). This is primarily because such patients can react roughly in case of severe post-operative pain while making the assessment procedure more difficult for the health care practitioners. However, this can be tackled through addressing patient’s depression issues, fear and anxiety related to the treatment or any other aspect. Recommendations Following are the recommendations regarding post-operative pain assessment: 1) Use of correct and validated tools: The two types of pain assessment tools i.e. uni-dimensional and multi-dimensional are used as per the individual requirements of the surgery. Above discussion reveals that the use of inappropriate validation tools can make the overall assessment significantly difficult whereas the results generated from such assessments are hard to interpret. 2) Good communication with regard to description of pain: Effective communication is an essential element of post-operative pain assessment and therefore medical professionals are required to be pragmatic and compassionate. Moreover, it is necessary for them to enhance listening skills in order to report patient’s history in a well organized form. 3) More robust training on pain assessment during pre-registration courses: Since post-operative pain assessment has become a significant issue in health care therefore practitioners are now required to have extensive training courses on pain assessment and management in the pre-registration period. This will actually help them in achieving professional excellence while providing satisfactory pain relief services. 4) Patient education and empowerment: Above research and discussion indicates that educating patients about different aspects of surgery can radically help in post-operative pain assessment. Therefore health care institutions should now implement laws particularly for patient education and empowerment. Practitioners should be encouraged to give more time in consulting patients while addressing their surgery related concerns and psychological stress. Works Cited Corke, Philip. Postoperative pain management. Australian Prescriber. 2013. Web. 13 July 2014. Fenech, Thomas & James Diamond. Specialist Accreditation Committee Medical Training Programme. Malta: Department of Ophthalmology Mater Del Hospital , 2008. Mackintosh, Carolyn. "Assessment and management of patients with post-operative pain." Nursing Standard (2007): 49-55. Read More