Authors (including presenting author) :
Lai MHW(1), Chan TMJ(1),Law KY(1)
Affiliation :
(1)Palliative Care Unit, Our Lady of Maryknoll Hospital
Introduction :
To increase Pain Link Nurse's awareness and engagement in daily pain management. To optimize pain control in general medical ward.
Objectives :
From 23 April to 13 August 2018, general medical patients were recruited for the Log Book Exercise on admission if the pain score was 2 on Verbal Rating Scale by convenient sampling. Tasks in the “Pain Link Nurse Log Book” were completed by implementing the “Flow chart of nursing intervention on pain management”, in which the steps comprise “5As” as the mnemonics: Assess, Administrate, Alert, Alternate and Appraise. The objectives are to increase Pain Link Nurse’s awareness and engagement in daily pain monitor, drug administration, co-ordination with multiple disciplines, patient education and outcome evaluation.
Methodology :
A total of 106 inpatients with an average age 74, admitted with multiple acute or chronic diseases, were recruited during the period (55% male and 45% female). Forty-seven percent of patients had received regular analgesics while 81% were prescribed breakthrough analgesics. All patients had received non-pharmacological treatments to control pain from nurses. The most common interventions were education (87%), coaching on rest or appropriate exercise (76%) and emotional support (44%). More than 50% of patients had received counselling on drug regime, side effects and compliance. Half of the patients were referred to allied health care workers for pain management, such as assistive or adaptive manoeuvres. Average pain score on admission was 2.3 and it significantly decreased to 1.2 upon discharge. No patients had their pain got worse. Greater reduction of pain from baseline was observed when patients were given more doses of breakthrough analgesics. Score reduced by 1.7 when given >3 doses breakthrough against 1 with 1-3 doses. Empowering nurses in pain management should be competence-targeted and service need targeted. The Log-Book Exercise provides a useful framework for nurses to initiate, practice and improve pain control through patient-centred approaches. With enhanced professional development, Pain Link nurses could become a valued advocate in pain management at the ward level. Health care providers aim at achieving better health for people living with pain. Substantial changes are expected to fill the existing gap and effective pain management improves the overall quality of care. All patients should be frequently assessed for interruptions in pain control.
Result & Outcome :
I DISAGREE to send the abstract to Continuous Quality Improvement Initiatives System (CQIs) for sharing after HA Convention.
