Pain And Comfort
ANSWERS
Inadequate pain management can result in adverse physical and psychological outcomes for individual patients and their families. Unrelieved pain activates the pituitary-adrenal axis, suppressing the immune system and leading to postsurgical infection and poor wound healing. Sympathetic activation can harm the cardiovascular, gastrointestinal, and renal systems, predisposing patients to cardiac ischemia and ileus complications. Unrelieved pain, in particular, reduces patient mobility, resulting in complications such as deep vein thrombosis, pulmonary embolus, and pneumonia. Postsurgical complications, poor insufficient pain, and harm impact the patient’s welfare and hospital performance due to increased lengths of stay and readmissions, both of which raise the cost of care.
Continuous, unrelieved pain impacts the patient’s and family’s mental health. Anxiety and depression are common psychological responses to pain. The inability to escape pain can lead to helplessness and even hopelessness, leading to more chronic depression. Patients with poor pain management may hesitate to seek medical care for other health issues.
Clinicians who fail to manage pain effectively may face legal consequences. Current pain management standards, such as those outlined by the Joint Commission (formerly known as the Joint Commission on Accreditation of Healthcare Organizations, JCAHO), require that pain be addressed and managed as soon as possible. Having standards of care in place increases the risk of legal action against clinicians and institutions for poor pain management. There have been cases of physicians being sued for poor pain management. As members of the collaborative team in charge of pain management during hospitalization, nurses may also face legal consequences.
If pain is poorly managed, hospitals risk losing both reputation and profit. Patient satisfaction with care is strongly related to their experiences with the pain while in the hospital. Evidence suggests that higher levels of pain and depression are associated with lower satisfaction levels with care in ambulatory settings. With the advent of transparent health care, hospital report cards are becoming more common, and pain management performance is likely to be one of the indicators reported.
QUESTION
Pain And Comfort
1. Read chapter 27 in your text: “Pain and comfort,” provide a summary of what has been written regarding pain in the older adult population.
2. Identify factors that affect the pain experience in older adults.
3. Identify barriers that interfere with pain assessment treatment.
4. Address the key components of a nursing assessment and data to include in a pain assessment.
5. Discuss pharmacological and nonpharmacological pain management therapies.
6. Discuss how the gerontological nurse can develop a care plain to care for an older adult with pain.
How can the geriatric nurse help to advocate and improve the care of older adults as it relates to pain management including nursing interventions or
teaching and education using evidence-based research.