Language
Country/Area
No result found
Did you know? Pain can be quantified! How about using a numbers and face scoring system?
In healthcare, pain is often considered the fifth vital sign. Medical professionals recognize that pain is not just a subjective feeling, but an objective phenomenon. Therefore, nurses receive necessary training in pain assessment, and this assessment is increasingly valued in today's healthcare system.
Assessment of pain and re-evaluation after administration of analgesics are regulated by the accrediting agency for healthcare facilities.
Norms
The Joint Commission, which established standards for pain assessment for the first time since 2001, noted that the route of analgesic administration affects the time to reassessment of pain because different routes of administration require different times to produce effects.
- Oral administration: 45-69 minutes
- Intramuscular injection: 30 minutes
- Vascular injection: 15 minutes
Assessment type
Most pain assessments rely on some form of assessment scale, usually before any medication is administered, and after a specified period of time, the effectiveness of the treatment is measured.
Numeric scale
Patients rate pain on a scale of 0 to 10, where 0 represents no pain and 10 represents the worst pain imaginable.
Face scale
Healthcare professionals show patients a series of faces showing different levels of pain, and the patient chooses the face that best represents their pain.
Special Considerations
For patients who are unable to speak or understand pain scales, a different type of assessment scale is used, such as FLACC (for neonates and infants).
The FLACC scale calculates a pain score from 0 to 10 by summing the scores for each item.
Chronic pain and psychological measurement
Long-term pain often varies due to psychological adaptation, and actual long-term pain is often lower than expected. In addition, functional magnetic resonance imaging (fMRI) has also begun to be applied to the measurement of pain, showing good correlation with self-reported pain.
Law and Pain Assessment
In the legal field, accuracy in the assessment of pain and suffering is particularly important. In Western countries, these assessments are generally adjudicated by juries and are often considered unpredictable and quite subjective. The same is true in places like the United States, United Kingdom, Australia and New Zealand.
Potential risk of addiction
Many patients who use medications, such as opioids or other pain relievers, may be at risk for addiction. Many of these patients have a history of chronic illness, injury or mental illness, making it challenging for nurses to assess a patient's pain and often find it difficult to determine whether the pain is real or simply to obtain medication.
Nurse’s pain assessment
To ensure that the patient's pain is fully understood, nurses need to pay attention to non-verbal signs of pain, such as crying or facial contortion, whether the patient is given pain medication on time, and whether there are any mood changes.
During each nursing shift, nurses are required to assess patients and notify physicians if they identify possible addiction.
Evaluation results and follow-up actions
If the patient keeps asking the doctor to increase the dose of the medication or to take it more frequently, further evaluation is needed. This may indicate that the patient is suffering from physical pain, or it may mean that they are dependent on medications.
The nurse should consider the patient's history, diagnosis, and social background. For patients in long-term care facilities, three nonpharmacological interventions should be tried before anxiolytics or antipsychotics are administered. These interventions may include providing the patient with food, water, individual care, or adjusting their position in bed.
Final Thoughts
Given the subjectivity and complexity of pain, have you ever reflected on the way you perceive and evaluate pain?
