In information technology, a dashboard is a user interface that, somewhat resembles an automobile’s dashboard, organizing and presenting information in a way that is easy to read. Healthcare dashboards are designed to show the performance of key activities that directly or indirectly impact patient satisfaction, such as length of stay and lab test turnaround. This paper will take at look at pain response and breakdown why it is important and ways to improve it. Analysis of the data
In 1998, the National Database of Nursing Quality Indicators (NDNQI) was established by The American Nurses Association (ANA) so that the ANA could continue to collect and build on data obtained to ensure a better outcome for patients (Montalvo, 2007). The sample dashboard for the purpose of this paper, showed a decline in response to pain in 3 out of the 4 quarters surveyed. Despite the availability of analgesics, particularly opioids, and national guidelines to manage pain, the incidence of postoperative pain has remained stable over the past decade. Thus, acute pain associated with surgical and diagnostic procedures is a common occurrence in U.S. hospitals and remains inadequately managed for many patients (Hughes, 2008). Nursing Plan
To many times nurses don’t properly medicate patients, due to patients not correctly reporting their pain, or staff members commenting on how often they are requesting pain meds. In 1968, Margo McCaffery defined pain as “whatever the person experiencing says it is, and occurring when the person says it does.” (Martin, Kelly, & Roosa, 2012). Inadequate management of pain and other symptoms not only decreases the quality of life; it also creates a financial burden on the health care system and on our society. Unrelieved pain costs millions of dollars annually as a result of longer hospital stays, re-hospitalizations, and visits to outpatient clinics and emergency rooms (Berry & Dahl, 2000). On January 1, 2001, pain management standards went into effect for Joint Commission accredited ambulatory care facilities, behavioral health care organizations, critical access hospitals, home care providers, hospitals, office-based surgery practices, and long term care providers (The Joint Commission, 2014). The standards require the nurses to recognize the right of patients to appropriate assessment and management of pain, to screen patients for pain during their initial assessment and, when clinically required, during ongoing, periodic re-assessments, and educate patients suffering from pain and their families about pain management.
A proper assessment needs to be completed upon admission, and the physician needs to be contacted to ensure proper pain management is in effect. There are several different pain scales to be used based on the patient’s alertness and cognitive ability. The 0-10 Numeric Scale is the most widely used scale for patients who are alert and oriented. Wong-Baker FACES scale is used more with younger pediatric patients or mentally challenged. The FLACC scale is used for patients who can’t verbally or visually report their pain level. Once a patient has been assessed and proper treatment has been established, follow up is very important to maintain a proper level of pain control. It is the nurses responsibility to return to ask the patient how their pain is after intervention has been given. Typically if pain medication was administered you should reassess 30 minutes after IV medication and 60 minutes after oral medication. Don’t take it for granted if the patient is resting, some patients don’t physically show signs of pain.
Once the patient is ready for discharge, proper education about pain control needs to be instructed to the patient and family member. Explanations of why it’s important to continue the pain meds at home, medications to avoid while taking them, and side effects that may occur. If NDNQI results continue to decline in future reports, re-education of current staff should be performed. Pain management has often been referred to as the 5th vital sign, nurses and nursing assistants should be instructed to ask/assess about pain when taking vitals. Frequent chart audits should be conducted to ensure proper charting and pain interventions are occurring. Pain management starts with educating the staff on the proper assessments and following through on interventions implemented. Summary
In conclusion, for patients to have a better experience with their hospital stay, proper pain management needs to occur. With the correct orientation and training of staff to the different pain scales used, frequency of patients being asked about pain, and proper interventions being implemented, nursing scores for response to pain should increase.
Berry, P, PhD, RN, CRNH, CS, & Dahl, J, PhD. (2000). The new JCAHO pain standards: Implications for pain management nurses. Pain Management Nursing, Vol 1(Issue 1), 3-12. Retrieved from http://www.painmanagementnursing.org/article/S1524-9042(00)04110-2/abstract Hughes, R. (2008). Patient safety and quality: An evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality, U.S. Dept. of Health and Human Services. Martin, L., Kelly, M., & Roosa, K. (2012). Multidisciplinary approach to improving pain management. Critical Care Nursing Quarterly,35(3), 268-271. Montalvo, I., (September 30, 2007) “The National Database of Nursing Quality IndicatorsTM (NDNQI®)” OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 3, Manuscript 2. The Joint Commission. (2014, February 4). Retrieved September 21, 2014.