The perception of pain is handled differently by every patient, it is vital as healthcare providers that clinical guidelines are utilized when evaluating a child experiencing pain while utilizing the proper methods to manage their pain in an efficient and safe manner. Appropriate use of updated clinical guidelines on pain management can prevent oligoanalgesia the undertreatment of pain in pediatric patients. The use of proper guidelines can enforce an organized tactic technique to manage pain this is enforced with educated staff that will then provide proper care to pediatric patients during acute episodes of pain.
Since there are many different age groups when caring for pediatric patient’s health care providers must understand that there are several different developmental stages that must to be comprehended in order to provide proper care. Whereas their adult counterpart can express along with describe their pain on onset, there are many times that a pediatric will not be able that information. Since pain is the typically reason for parents to seek medical attention for their child as nurses its vital to ensure that not only do, we properly alleviate the child’s pain but also inform parents of what they can expect and educate them on how to use developmentally applicable strategies to help their child manage the pain.
In Newark Beth Israel Medical Center patient care is the highest priority especially in regard to pain assessment and management to ensure safety staff is educated on the facilities philosophy regarding pain management, which includes education on pain assessment, safe dosage of opioids, non-opioids therapy and equipment in order to delivery medication prior to patient contact. Since controlling the pain and stain is a vital component of pediatric care its essential to provide an appropriate management of analgesia.
Proper administration of pain relief which includes opioid and non-opioid methods can shape both the patient’s and families view on healthcare. The policy and procedure for pain assessment and management from Newark Beth Israel Medical Center states that upon arrival a patient is assessed for pain, using a scale based on their developmental age. In Newark Beth Israel Medical Center, they use scales such as;
- FLACC SCALE,
- Neonatal Infant Pain Scale (NIPs)
- CPOT Scale
- Faces Rating Scale
with these scale nurse can determine if their patients’ pain is mild, moderate, or severe. If the pediatric patient is admitted to the unit, they are then assessed once a shift, however, if the nurse deems necessary the patient’s pain is assessed as needed along with taking the patient verbal consideration into account. On the other hand, patients who are not admitted but are treated in the emergency room, same day surgery and special procedures they are assessed for pain each visit and whenever warranted.
If pain is assessed and identified by the nurse it is added and documented to the patients plan of care along with the proper education on different methods on how to control pain and their side effects are given to both the patient and guardian in order for to make an inform decision. Pain relief plan is to have the patient obtain a realist goal of pain which includes a pain assessment of The clinical guidelines for pain assessment and management provided to healthcare professionals at Newark Beth Israel Medical Center delivers the necessary information needed to provide care when attending to a patient exhibiting pain. Nonetheless, in recent research articles additional information has been provided to health care providers on how to properly assess their pediatric patient during moments of distress and how to manage these moments.
In the article “Pediatric Pain Management Emergency Medicine Clinics of North America, “written by Gaglani and Gross provides different methods on how to manage acute pain in pediatric patients. While it is imperative to attend to the patient whom it is in distress it is also imperative to reduce parental anxiety which is typically correlated with their child who is in pain.
While the Policy given in Newark Beth Israel Medical Center educates health professionals on how to rate and provide pain relief, they do not mention aspect that can alter pain management and assessment which is affected by the patient’s perception of their care. It is stated that “distraction techniques are useful to treat pain in preschool- and school-aged children, as well as in adolescents” (Galgaini & Gross, 2018). Since children who are younger in age have not all reached certain developmental stages comprehension and verbal reassurance is not always reliable the use of distraction can be beneficial in long term management.
In addition to the lack of different ways to manage comfort and assessment in their patient’s policy, Newark Beth’s Israel Medical center is also missing a section in which they discuss how to handle patients who have special needs and need special accommodates in order to self-report their pain or how-to nurses are able to observe changes to note that their pain is increasing. In the article “Pediatric Pain Management Emergency Medicine Clinics of North America, “written by Gaglani and Gross states that its vital that the management and assessment of those with “ developmental disorders, such as autism spectrum disorder, patients may manifest pain with changes in behavior, such as becoming aggressive toward self or others, sources of pain should be elicited in these patients presenting with behavioral complaints (Galgaini & Gross, 2018).
Those who are developmentally impaired may be incapable of verbalizing their pain level and where it is localized thus for this reason it’s vital to knowhow to perform different of assessments and observe the patient’s behavior to help lessen the patient’s anxiety which by be heightened due to possible pervious experiences. In addition to Gaglani and Gross suggestion on being informed and trained on special populations, they go on to further suggest that the presence of family especially the parents is critical and useful throughout painful procedures.
Despite the fact that Newark Beth Israel Medical Center does not provide different non-pharmacological techniques, both the policy from Newark and the “Pediatric Pain Management Emergency Medicine Clinics of North America (Galgaini & Gross, 2018) implement the use of assessment tools indicating that observational-behavioral along with self-report scales are two forms of pain assessment tools currently the standard in the assessment of pain. In addition, both the policy and article agree that treating children’s pain during acute settings is important along with the use of a combination of nonpharmacologic and pharmacologic techniques.
In the article “Pediatric Pain Management: An Evidence-Based Approach” by Luisa, Ramira, Instone, and Clark (2015) indicate that `numerous studies ranging from national, local and global results show that pediatric patients are not given sufficiently treat their pain compared to adults. Nevertheless, after providing the staff with proper education pain assessment and management among children improved. This concept of educating staff on the appropriate manner on how to manage and assess child in distress is reviewed in both this article and the policy provided to the health providers at Newark Beth Israel Medical Center.
However, one difference between them both is that policy provided to health care providers at Newark Beth Israel Medical Center are not told to take into account the challenges that can alter the accuracy of a pain assessment. These challenges can be a “the physical setting, crowding, stress, and lack of time for adequate patient assessment (Ramira, Instone, & Clark, (2016). Since health care providers utilize observation behaviors for the assessment of pain it’s imperative that younger pediatric patients are assessed correctly since these challenges regularly lead to incorrect management of painful conditions.
The article continues to state that nurse who typically assess the patients pain first, are included in the factor that result in poor pain control and poor pain management in children during acute pain episodes. It is suggested that nurses fail to “to use valid and reliable assessment tools appropriate to the child’s age, parental perception, nurses’ own personal beliefs, lack of triage protocols, and the misconception that children do not feel pain” (Ramira, Instone, & Clark, (2016).
- Clinical Practice Guidelines on Pain Management in Pediatrics
- Assessing and Managing Pain in Children
- Pediatric Pain: An Overview of Clinical Guideposts and Consideration for Treatment Decisions
- Pain Assessment in Children: The Quest for a Reliable and Specific Tool
- Best Practices for Postoperative Pain Management in Children