Nursing literature review pain management, literature review of pain management in dementia. research paper example : birchsidestudios.com
This group can cause gastric irritation and the use of a gastric protective drug is advised. It is assumed as the researchers indicated the use of another tool that this a limitation of this tool that it cannot be used as a stand-alone assessment. Molony asked nursing staff to document the frequency of assessment. Multimodal approaches toward relieving pain, patients' participation, and improving self-efficacy are important for chronic pain management. We identified possible options of pain management strategies and explored effectiveness of chronic pain interventions.
- Literature Review of Pain Management in Dementia. Paper
- Literature review of pain management for people with chronic pain.
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- Literature Review of Pain Management in Dementia. Research Paper Example : birchsidestudios.com
- Literature review of pain management for people with chronic pain.
Pain assessment. The use of documentation and the nursing literature review pain management of the nurse-to-nurse handover is not explored within the literature as a nursing literature review pain management to aid assessment both of which are commonplace in a nurses daily routine, which leads me to believe that both these activities happened but were not documented by the researchers. She supports this with several anecdotal accounts from staff.
This review found many omissions in the research but this could be due to the fact that certain activities are commonplace and the expectation is on the reader to assume these activities happen. Introduction Pain Pain can be a common experience for many older adults and has negative effects on their health, functioning and general well being Pain presents an enormous challenge for most nurses within their daily working lives.
Literature Review of Pain Management in Dementia. Paper
The use of many databases was deemed necessary due to the specialism the enquiry relates to as research in dementia is still relatively new. The ethical issue as to whether analgesia will hasten death is identified within the literature as a concern for nurses and relatives. There are other tools identified within the literature but due to the frequency that it was referenced and studies that included it within their framework the critique of literature in regard to this tool seemed most relevant.
Most self report tools focus on pain intensity these include The visual analogue scale VAS which asks a client to select a number between 1 and 10 and the verbal rating scale VRS where you ask the client to verbalise their pain on a scale between no pain and worst pain possible. The key to therapeutic success is how well are the symptoms being relieved. Kovach reports that the treatment strategies used by nurses are poorly understood.
Literature review of pain management for people with chronic pain.
Also omitted was the use of do not escalate or do not resuscitate order and what they men to the client receiving palliative care and in the age of the expert patient many making advance directives and how this dictates the care we can give as nurses, do we have the right to override these statements if we deem it to be in the clients clinical best interests and where does this feature in the assessment process.
These changes affect the client in several ways. Evans and Kovachs work highlights that Feldt tool is not comprehensive, as it does not highlight what people are trying to communicate with their ongoing behaviours and that it can only be used at that snapshot in time, this factor is something that was not identified nursing literature review pain management the authors.
The tool is designed as an observational tool for use by nursing staff. Appropriate assessment and management of pain should be paramount to nurses working in the elderly care sector. Literature review of pain management for people with chronic pain.
Panke points out that behavioural cures are not always reliable, as moaning and grimacing are symptoms that occur with delirium as a common factor in the client in the end stage of life and that this may require assessment for both causes. All literature that cites the TENS also states it should not be used for first line pain relief.
It would be beneficial to further explore the importance of the skills needed by the nurse in this area of care.
The need for appropriate nurse education has been highlighted throughout the review and that most nurses felt that they did not have sufficient knowledge to care for these clients, this is something that needs urgent address in order to provide a good quality of service. Is this due to the nurse being perceived as the expert or are families at this distressing time not considered to be able to give eliable information.
I have commonly seen it myself in practice that a low dose antipsycotic is very effective.
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Conclusion There is a clear need to address this issue as the proportion of people with dementia is likely to increase along with the increasing proportion of elderly persons in the population as due to more effective health care people are living longer.
The American geriatric society believe that clients with dementia are at high risk for unidentified and under treated pain. A Diamorphine as opposed to morphine is commonly the drug of choice for subcutaneous administration due to greater solubility. There are several methods of pain assessment identified within the literature.
No mention is made in the research year 4 english homework activities to the impact of hospital policy on the treatment of these clients and whether there are set standards dictated from trust level. The review was not limited to a study design type as most papers identified are qualitative and give anecdotal evidence.
There is no clear definition attached to this tool as to how the score correlates to pain intensity, the papers that reviewed this tool recommended that it be used nursing literature review pain management conjunction with a self reporting tool but also if there were any behavioural indicators of pain scored present further investigation and treatment should be actioned.
As with all older adults, clients with dementia present with chronic conditions such as arthritis and acute pain experienced in the aging and the end of life process. This requires business plan on boutique ppt exploration as to the benefit of relatives input in a clients care.
Also how often this tool should be utilised is not explored would it be beneficial to use it daily or just when the nursing staff notice change. This impairment potentially results with individuals unable to express pain and report it appropriately.
The findings of this study could have been strengthened by the use of a control group of nurses already competent in the assessments to provide a conclusive baseline that nurses should attain friends reunited case study a larger sample size. It is noted that aging has an affect on the effect of the drug on the client and also the concentration of the active drug is affected.
The issue of constipation was also raised by Panke as a common side effect of analgesics that was likely to cause pain and recommended that clients should be prescribed laxatives as a matter of course.
Recent research by the Joseph Rowntree foundation indicates that these problems could be overcome by the use of the NICE guidelines for analgesia these recommend regular administration and treatment adjusted from one step to the next according to increasing or year 4 english homework activities pain severity, history of analgesic response and any side effects.
This is in conflict with the NMC code of conduct that states it is the nurses own responsibility to update her practice and therefore ward staffing should not be an issue although many trusts have policies to support learning and development.
Hire Writer Nurse education is still an unmet need within this another word for thesis of practice. Published work related to pain management in individuals with chronic pain was identified by searching databases and reviewed.
This approach also calls into question the use of as required medication and its prevalence. Evans reviewed the literature and other research within her study, she found that educational initiatives that address clinical skills in pain and symptom management were required.
The paper cyber security thesis paper in the positivist paradigm was a correlation design that examined the relationship between two variables in this instance pain and agitation and generated results of a quantative nature.
Panke believes you should consider all cue verbal and non-verbal and nursing literature review pain management continual reassessment of these cues is vital.
The most commonly referenced tool within the literature is The Checklist of Nonverbal Pain Indicators CNPI by Feldtresearch on this tool by Horgas and Davie have deemed this to be an effective tool to use within dementia care. Gradual titration is recommended to over come this.
- Another reason maybe that the cognitively impaired are often excluded from research studies, as they are unable to give adequate feedback to fulfil the researchers needs for the inclusion of data.
- Also omitted was the use of do not escalate or do not resuscitate order and what they men to the client receiving palliative care and in the age of the expert patient many making advance directives and how this dictates the care we can give as nurses, do we have the right to override these statements if we deem it to be in the clients clinical best interests and where does this feature in the assessment process.
- The research question they posed was that cognitively impaired nursing home residents might not be prescribed adequate analgesia.
Epps believe that nurses often under report pain of clients with dementia. Although pain assessment and treatment is complicated with the client with dementia. Another reason maybe that the cognitively impaired are often excluded from research studies, as they are unable to give adequate feedback to fulfil the researchers needs for the inclusion of data.
Nurses need to be aware of all possible sources of information when assessing clients with dementia and other conditions that impair communication and take into account non verbal behavioural cues such aggressiveness and increased vocalisation. Horgas identified the considerations for administering analgesics in the elderly.
Although this gives a broad definition of the symptoms, dementia is actually a disease caused nursing literature review pain management permanent brain changes and loss of neurons. Nursing literature review pain management barrier to effective pain management is a failure to assess pain. Cohen Mansfield et al also concluded through their study that assessment is made further difficult as the client group expressed discomfit Constipation, emotional distress, cold and hunger in the same ways such as calling out and increased agitation.
Findings The findings will be divided into two sections pain assessment and pain management. This may be due to opioid toxicity, a recommendation of haloperidol is recommended for drug toxicity.
Pain management Horgas and Tsai investigated prescription administration of analgesic medication of clients with cognitive impairment. Haloperidol also can assist with nausea and vomiting.
This group can cause gastric irritation and the use of a gastric protective drug is advised. We identified possible options of pain management strategies and explored effectiveness of chronic pain interventions.
Literature Review of Pain Management in Dementia. Research Paper Example : birchsidestudios.com
The literature mainly identifies methods of drug administration and drug type most appropriate to the client group. It may be worthwhile to repeat these studies in an impatient dementia environment to test the validity of the results. Pain management that includes both pharmacological and non-pharmacological measures was considered nursing literature review pain management be effective.
The research question they posed was that cognitively impaired nursing home residents might not be prescribed adequate analgesia. With nurses interviewed by moss asking what is permissible? Chronic pain conditions may include arthritis, gout and peripheral vascular disease, acute conditions such as cancer; cardio vascular disease and surgery are also prevalent causes of pain.
Nurses only commonly used morphine for severe pain and to promote comfort during dying.
Literature review of pain management for people with chronic pain.
Kovach identified that fentanyl was more commonly used than morphine in the relief of clients pain. It is because of this that the need to review best management is vital. This requires further research. Kovach found that nurses felt that narcotics were underused but appreciated the value of them to maintain comfort and dignity.
Other examples involve volunteering and coaching, or starting new programs in your classrooms and school. Network with neighbors.
It is because of these contrasts that it would be beneficial to explore behavioural tools and other curriculum vitae europeo ed europass differenze as essay turkey bacon means of supporting self-report tools in order to gain comprehensive assessment.
The search returned nine articles that fully met the inclusion criteria these nursing literature review pain management been included in the review. This review explores the findings drawn from the research. It is assumed as the researchers indicated the use of another tool that this a limitation of this tool that it cannot be used as a stand-alone assessment.
This is internet censorship thesis statement true within old age psychiatry as if a client is in pain it may be impossible to recognise a pure diagnosis of agitation or depression and intervene accordingly nursing literature review pain management there is the possibility that these symptoms may be reactive due to inadequate pain relief.
Cohen Mansfield study was extremely limited as it was restricted to one nursing home with a very small sample all of which had a moderate dementia and had been placed there for over two years. Pain assessment is the important first step in effective pain management. Inclusion criteria are as follows: An elderly client may present with more than one friends reunited case study of pain in different locations with varying causes making the nurses job all the more challenging.
Individuals with chronic pain reported that strategies including pharmacotherapy, physical activity, social support from friends and family, acupuncture, heating, rest, diets, or life-style changes helped them to effectively manage their pain.
Behavioural indicators of pain as outlined by Evans in addition to those in Feldts tool are aggression, loss of appetite and withdrawal Kovach further expands on this by advising staff nrich problem solving ks2 fractions look for changes in mobility and respiration. Kovach found that nursing staff prioritised comfort over issues such us regents essay rubric side effects or toxicity.
Anecdotal evidence may not be seen as the most reliable Parahoo but there are reasons why within this area of research most results fit into this category.