Post-Operative Pain Management
Clinical Analysis: Post-Operative Pain Management
ORTHOPAEDIC ward pain management and assessments done by nurses post operations
Clinical Analysis: Post-Operative Pain Management
The quality of care provided immediately after a surgery defines the health and wellbeing of the surgical patient. Post-operative care focuses on critical areas such as pain control and management, preventing complications by encouraging early mobilization, ensuring adequate nutrition, and preventing pressure sores and skin breakdown. In the orthopaedic ward, post-operative care is fundamental in promoting the health of the patient and ensuring a quick recovery. Pain is a presenting symptom that provides clinical information useful in helping the patient and alleviating pain. Anticipating the pain needs of the patient and offering timely, quality, safe and effective care is critically important in the orthopaedic ward. The effectiveness of the pain management process is determined by the post-operative observations and assessments used by the anaesthesiologists, nurses, and surgeons in assessing and managing the post-operative pain. This paper offers an articulate discussion of the observations and assessments used in the orthopaedic ward for managing post-operative pain and integrates deeper research to show the reflection of the best practices in literature.
Assessing and Managing Post-Operative Pain
As care providers in the orthopaedic ward focus on alleviating pain and reducing patient suffering, pain assessment is necessary. According to Pogatzki-Zahn, Segelcke, and Schug (2017), the assessment determines the nature and degree of the pain, and the necessary analgesia or nondrug approach to pain management. In the process of delivering the post-operative care, the carer must understand the importance of safe, effective, and quality care (National Pain Strategy, 2010; Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine, 2015). The effectiveness of the pain management process through the integration of pain assessment and observation ensures comfort, reduced anxiety, prevents complications and facilitates recovery. In the Australian orthopaedic wards, the nurses, anaesthesiologists, and members of the surgical team are tasked with the responsibility of providing safe, effective, and quality care that guarantees effective pain management (Clarke & Santy-Tomlinson, 2014). Key in the process of alleviating and managing pain are the processes of assessment and observation (National Pain Strategy, 2010). The practices allow the carers to apply the primary methods for the alleviation of pain including the use of analgesia and nondrug approaches.
According to Frizzell, Cavanaugh, and Herman (2017), assessing pain and observing patients after orthopaedic surgery is fundamental in the management of their pain and improvement of their process of recovery. Clarke and Santy-Tomlinson (2014) and Pasero and McCaffery (2007) state that effective assessment of pain depends greatly on the efficiency of the communication between the post-operative nurses and the patient. While supporting Clarke and Santy-Tomlinson (2014), Chan, Blyth, Nairn, and Fransen (2013) assert that communication allows the care provider to understand if and when the patient experiences pain. The process allows the adoption of the necessary measures to ease the pain. The National Pain Strategy (2010) supports the finding that communication is key in assessing and observing for pain management but indicates that in most cases of severe injuries and trauma, the patient is incapable of effective communication. Schmelling, Poulsen, Christrup, and Gazerani (2017) states that observation is used in cases where the patient cannot communicate or respond due to injury or trauma. In this regard, effective communication and observation are termed critical in assessing and managing pain in the orthopaedic ward.
Literature on post-operative pain management outlines the best practices. According to Pasero and McCaffery (2007) and Schmelling, Poulsen, Christrup, and Gazerani (2017), the management of post-operative pain minimizes secondary morbidity and the possible development of chronic pain. The correct management of pain in the orthopaedic ward improves the recovery process and enables patients to recuperate wholly (Chan, Blyth, Nairn, & Fransen, 2013). The application of the pain management measures allows the prevention of long-term or chronic pain. Ebert and Joss (2013) and Corke (2013) discuss the post-operative pain management in depth, outlining the best practices identified in the provision of the post-op pain management care. According to Pasero and McCaffery (2007), offering post-op pain management care involves dealing with acutely admitted patients and other patients. The patients show varying levels of pain depending on their injuries and types of surgeries performed (Corke, 2013). Integrating effective communication and observation helps the surgeon, nurse or anaesthesiologist understand when the patient is experiencing pain, and the level of pain, enabling the use of analgesia for pain alleviation (Pogatzki-Zahn, Segelcke, & Schug, 2017).
The process of managing pain after an orthopaedic surgery follows post-op pain assessment. Pasero and McCaffery (2007) state that the use of a scale for in-the-moment assessment using either multi- or uni-dimensional tools for the transfer of the subjective and individual pain experience to the scale enables effective communication and evaluation in the process of care. While supporting the statement, Schmelling, Poulsen, Christrup, and Gazerani (2017) argue that communication remains central in the process of alleviating pain post the operation, but acknowledges the importance of pain assessment instruments. The integration of assessment instruments with effective communication and measures for alleviating the pain improves the quality of care and the health of the patient (Frizzell, K.Cavanaugh, & Herman, 2017; Corke, 2013).
experiencing acute or chronic pain from injuries require quality care that
reduces their suffering and promotes their process of recovery. Post-operative
assessments and observations are critical practices that help the carer to
understand when the patient is experiencing pain, the level of the pain, and
the measures for reducing the pain. Some of the fundamental elements of the
assessment and observation include communication, engaging the patient directly
through questions, observing the patient, and using the pain assessment
instruments. The observations and assessments help identify the effective
nondrug and analgesic approaches to pain management. Literature reflects and
supports the effectiveness of assessing and observing in post-operative pain
management. However, in the management of pain, especially in the orthopaedic
ward, there is a need to consider the status of the patient to determine the
necessary approach to assessing, observing, and managing pain. The safety and
effectiveness of the pain management following an orthopaedic surgery are
Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine. (2015). Acute pain management: scientific evidence. Retrieved from Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine: https://fpm.anzca.edu.au/documents/fpm-apmse4-final-20160426-v1-0.pdf
Chan, E. Y., Blyth, F. M., Nairn, L., & Fransen, M. (2013). Acute postoperative pain following hospital discharge after total knee arthroplasty. Osteoarthritis and Cartilage, 21(9), 1257-1263.
Clarke, S., & Santy-Tomlinson, J. (2014). Orthopaedic and trauma nursing: an evidence-based approach to musculoskeletal care. Sydney: Wiley.
Corke, P. (2013). Postoperative pain management. Australian Prescriber, 36, 205.
Ebert, J., & Joss, B. (2013). Post-operative management following orthopaedic surgery for common knee surgeries: evidence-based and clinically designed rehabilitation leads to better outcomes. Nedlands: Exercise and Sports Science Australia.
Frizzell, K. H., K.Cavanaugh, P., & Herman, M. J. (2017). Pediatric perioperative pain management. Orthopedic Clinics of North America, 48(4), 467-480.
National Pain Strategy. (2010). National Pain Strategy: Pain Management for all Australians. Melbourne: Australian and New Zealand College of Anaesthetists; National Pain Strategy.
Pasero, C., & McCaffery, M. (2007). Orthopaedic postoperative pain management. Journal of Perianesthesia Nursing: Official Journal of The American Society of Perianesthesia Nurses, 22(3), 160-172.
Pogatzki-Zahn, E. M., Segelcke, D., & Schug, S. A. (2017). Postoperative pain—from mechanisms to treatment: Acute Pain Management: Scientific Evidence of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine. Pain Reports, 2(2), e588.
Schmelling, W., Poulsen, J. N., Christrup, L., & Gazerani, P. (2017). Pain assessment and post-operative pain management in orthopedic patients. Scandinavian Journal of Pain, 181.