Pain management in nursing practice in the emergency department

  • Mauro Mota Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal | Unidade Local de Saúde da Guarda, Guarda, Portugal
  • Madalena Cunha Instituto Politécnico de Viseu, Escola Superior de Saúde, UICISA:E, SIGMA – Phi Xi Chapter, CIEC - UM, Viseu, Portugal
  • Margarida Reis Santos Escola Superior de Enfermagem do Porto, CINTESIS, Porto, Portugal
  • João Duarte Instituto Politécnico de Viseu, Escola Superior de Saúde, CI&DETS, Viseu, Portugal
  • Ana Raquel Rocha Instituto Politécnico de Viseu, Escola Superior de Saúde, Viseu, Portugal
  • Ângelo Rodrigues Instituto Politécnico de Viseu, Escola Superior de Saúde, Viseu, Portugal
  • Carolina Gonçalves Instituto Politécnico de Viseu, Escola Superior de Saúde, Viseu, Portu
  • Rúben Ribeiro Instituto Politécnico de Viseu, Escola Superior de Saúde, Viseu, Portugal
  • Sandra Sobreira Instituto Politécnico de Viseu, Escola Superior de Saúde, Viseu, Portugal
  • Susana Pereira Instituto Politécnico de Viseu, Escola Superior de Saúde, Viseu, Portugal
Keywords: pain, pain management, evidence-based practice

Abstract

Introduction: In Portugal, more than 30% of adults have chronic pain and acute pain is the main reason for hospital admission, representing 5 billion euros annually, 2.7% of Gross Domestic Product. 

Objetives: Assess the practices and factors involved in pain management by nurses in an Emergency Department.; 

Methods: Cross-sectional, analytic study, conducted in an emergency setting. Sample consisted of 96 nurses. The data collection instrument contained questions of socio-professional characterisation, the Scale of Nursing Practices in Pain Management of Catarina António and the Visual Pain Code of Grünenthal. 

Results: The pain assessment scale most commonly used by nurses was the Numerical Rating Scale (88.5%); nurses with more experience in the Emergency Department (>=11 years) showed a greater lack of knowledge (37.5%) and the majority (53.8%) of those with good knowledge about this code worked between 6-10 years (p=0.021). 

Conclusions: We believe that nurses need to deepen their knowledge about the principles of pain assessment and management. The constant and targeted updating of training will contribute to a better daily clinical practice. 

References

Allen, E., Williams, A., Jennings, D., Stomski, N., Goucke, R., Toye, C., & McCullough, K. (2018). Revisiting the Pain Resource Nurse Role in Sustaining Evidence-Based Practice Changes for Pain Assessment and Management. Worldviews Evid Based Nurs, 15(5), 368-376. DOI:10.1111/wvn.12318

Almeida, V. (2015). A avaliação da dor no doente cirúrgico com alterações cognitivas. Viseu: Instituto Politécnico de Viseu. Escola Superior de Saúde de Viseu.Acedido em http://repositorio.ipv.pt/bitstream/10400.19/3052/1/ALMEIDA%2C%20VeraLuciaBarbosa%20DM.pdf

António, C., Santos, E., Cunha, M., & Duarte, J. (2019). Estudo psicométrico da Escala de Práticas de Enfermagem na Gestão da Dor. Revista Referência.

APED. (2013). Declaração de Montreal. Retrieved from Associação Portuguesa para o Estudo da Dor: http://www.aped-dor.com/index.php/a-aped/declaracao-de-montreal.html

Azevedo, L., Costa-Pereira, A., Mendonça, L., Dias, C., & Castro-Lopes, J. (2016). The economic impact of chronic pain: a nationwide population-based cost-of-illness study in Portugal. Eur J Health Econ, 17(1), 87-98. DOI:10.1007/s10198-014-0659-4

Azevedo, L., Costa-Pereira, A., Mendonças, L., Dias, C., & Castro-Lopes, J. (2018). Epidemiology of chronic pain: a population-based nationwide study on its prevalence, characteristics and associated disability in Portugal. J Pain, 13(8),773-83. DOI:10.1016/j.jpain.2012.05.012

Cardoso, A. (2013). Manual de Tratamento da Dor. Lisboa: Lidel.

Carvalho, M. (2016). O Sistema de Triagem de Manchester e a avaliação da pessoa com dor. Coimbra: Escola Superior de Enfermagem de Coimbra. Acedido em repositorio.ipv.pt/bitstream/...19/.../ALMEIDA%2C%20VeraLuciaBarbosa%20DM.pd.

Curtis , L., & Morrell, T. D., T. (2006). Pain management in the emergency department. Emergency Medicine Practice, 8(7), 1-28.

Decosterd , I., Hugli, O., Tamchès, E., Blanc, C., Mouhsine, E., & Givel, J. (2007). Oligoanalgesia in the emergency department: Short-term beneficial effects of an education program on acute pain. Annals of Emergency Medicin, 50(4), 462-471.

DGS (2003). Circular normativa nº 9/DGCG: A dor como 5º sinal vital. Registo sistemático da intensidade da dor. Direção-Geral da Saúde.

DGS (2013). Plano estratégico nacional de prevenção e controlo da dor (PENPCDor). Direção-Geral da Saúde. Acedido em http://www.dgs.pt/outros-programas-e-projetos/paginas-de-sistema/saude-de-a-a-z/plano-estrategico-nacional-de-prevencao-e-contr

Ferreira, L. (2013). Prevalência de Dor em Emergência Pré-Hospitalar. Viseu: Instituto Politécnico de Viseu - Escola Superior de Saúde de Viseu.

Ferreira, N., Miranda, C., Leite, A., Revés, L., Serra, I., Fernandes, A., & Freitas, P. (2014). Pain and Analgesia in Critical Illness. Rev Clin Hosp Prof Dr Fernando Fonseca, 2(2), 17-20.

Germossa, G., Sjetne, I., & Helleso, R. (2018). The Impact of an In-service Educational Program on Nurses’ Knowledge and Attitudes Regarding Pain Management in an Ethiopian University Hospital. Frontiers in Public Health, 6, 229, 1-7.

Gouveia, M., & Augusto, M. (2011). Indirect costs of chronic pain. Rev Port Saúde Pública, 29(2), 100-107.

Grant, M., Ferrel, B., Hanson, J., Sun, V., & Uman, G. (2011). The enduring need for the pain resource nurse (PRN) training program. J Cancer Educ, 26(4):598-603. DOI:10.1007/s13187-011-0268-1

Grunenthal. (s.d). Código Visual da Dor de Grunenthal. Algés: Grünenthal S.A. Portugal.

International Association for the Study of Pain. (2018). IASP - International Association for the Study of Pain. Acedido em https://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698#Pain

International Council of Nurses (2011). CIPE - Classificação Internacional para a Prática de Enfermagem Versão 2. Genebra: Ordem dos Enfermeiros.

Marôco, J. (2018). Análise Estatística com o SPSS Statistics (7 ed.). Pêro Pinheiro: ReportNumber.

Motov, S. (2012). Acute Pain Management in the Emergency Department: The Evidence‐Based Approach to Controversial Issues. EMedHome.

Ordem dos Enfermeiros. (2008). Dor - Guia Orientador de Boa Prática. Lisboa: Ordem dos Enfermeiros. Acedido em https://www.ordemenfermeiros.pt/arquivo/publicacoes/Documents/cadernosoe-dor.pdf

Pestana, M., & Gagueiro, J. (2014). Análise de dados para Ciências Sociais - A complementariedade do SPSS (6 ed.). Lisboa: Sílabo.

Pines, J., & Hollander, J. (2008). Emergency department crowding is associated with poor care for patients with severe pain. Annals of Emergency Medicin, 51(1), 1-5.

Simon, B., Scallan, E., Carrol, G., & Steagall, P. (2017). The lack of analgesic use (oligoanalgesia) in small animal practice. J Small Anim Pract, 58(10):543-554. DOI:10.1111/jsap.12717

Published
2020-06-01
Section
Life and Healthcare Sciences