Pain Assessment Literature Review

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Literature Review on Pain Assessment
The purpose of this review was to outline and evaluate pain assessment techniques and tools commonly used in the postoperative recovery room to assist in pain management.
Problem Identification and Evidence
Pain after surgery is stressful to patients and is a major problem in post anesthesia care unit (PACU). Recent data suggest 80 percent of patients experience pain post operatively (Wells, Pasero, & McCaffery, 2008). Ineffective pain management in the immediate postoperative period can prolong the patient’s length of stay in Post Anesthesia Care Unit (PACU) which may lead to increased cost of care (Wells, Pasero, & McCaffery, 2008). Poor assessment of pain is a huge obstacle to successful post-operative
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The original search using the search terms: pain assessment, and pain management, post surgical and PACU nurses, published between 2001-2016. The study members included nurses who are participated in the assessment and management of pain in patients post surgery. Other criteria for inclusion in each database were English language, full text articles, and studies published within the last 15 years, 2001 to 2016. Brown implements a very important point when she quotes Kehlet and Dahl (2003), “the practical aims of pain relief are to provide subjective comfort and enhance the patient’s ability to deep breathe, cough and move easily, thus avoiding postoperative complications.” Pulmonary atelectasis is the main concern for postoperative nurses due to patient’s lack of deep breathing because deep breathing usually increases pain. I also agree with Brown that achieving ‘subjective comfort’ is challenging and that many times it is difficult for both the patient and the nurse to have a mutual understanding of the specifics of the patient’s pain, such as intensity, quality, and location, because of the patient’s age, educational level, language barriers, and cognitive …show more content…
These tools can be used at the nurse’s discretion assisting in the documentation and the measurement of pain and ultimately, pain relief, as well. Brown also describes that these pain scales have limitations because they do not take into account important details of the pain such as location, intensity, duration, etc. Brown describes additional challenges in the management of pain for those with chronic pain conditions, pediatric and elderly populations and those with all levels of cognitive impairments and which of the pain scales can best be utilized in the management of pain. Despite the accessibility of proven assessment tools for pain in children, the Shrestha-Ranjit & Manias (2010) journal indicates that nurses tend to use pain assessment tools in limited ways and several studies have reported that children receive significantly less analgesic than recommended amounts. Nurses only administered a mean of 22% of available total analgesic doses to these children (Shrestha-Ranjit & Manias,

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