RECOVERY NURSES KNOWLEDGE

Recovery nurses knowledge and understanding of patient at risk scoring tool?

[Name of the Institute]

[Name of the Instructor]ABSTRACT

The Critical-Care Pain Observation Tool (CPOT) is one of the few behavioural pain scales which have been developed and validated for the purpose of detecting pain in nonverbal critically ill adults. This study will aim to complete a pre and post evaluation of the implementation of the CPOT on pain assessment/management nursing practices in the Intensive Care Unit (ICU) with nonverbal critically ill adults. A before-and-after study design will be used. Setting/Participants: The Intensive Care Unit (ICU) of a university affiliated health care centre will be selected for the implementation of the CPOT. All ICU nurses will be trained to use the CPOT. Medical files will be selected if the patient is 18 years or older, had been mechanically ventilated for a period = 24 hours, is unable to communicate, and had intact motor function.

TABLE OF CONTENT

CHAPTER 1: INTRODUCTION4

CHAPTER 2: LITERATURE REVIEW7

The Critical-Care Pain Observation Tool (CPOT)7

Risk in Nursing8

The safety v. autonomy dilemma10

CHAPTER 3: METHODOLOGY13

Independent variable: Implementation of the CPOT14

Dependent variables15

Data Analysis15

REFERNCES17

CHAPTER 1: INTRODUCTION

Collaborative efforts of the entire health care team must be coordinated, and participation of the patient and family in care must be encouraged. The patient's knowledge of the disease is determined, misinformation corrected, and oral and written information supplied about the disease, its progression, its treatment, and expected outcome. Such information should be updated on a regular basis. The patient's and family's positive coping mechanisms are identified and supported, and verbalization of feelings and fears, particularly with regard to changes in body image, pain and suffering, and dying and death, is encouraged. Participation in local support groups is encouraged for both patients and families.

Assistance is provided with personal hygiene and physical care as needed. Physical care is directed at the maintenance of fluid and electrolyte balance and proper nutrition. Nutrition is a special concern because tumors compete with normal tissues for nutrients and grow at their expense and because the disease or treatments can cause anorexia, altered taste sensations, mouth ulcerations, vomiting, diarrhea, and draining fistulas. Nutritional support includes assessing the patient's status and problems, experimenting to find foods that the patient can tolerate, avoiding highly aromatic foods, and offering frequent small meals of high-calorie, high-nutrient soft foods along with fluids to limit fatigue and to encourage overall intake. Intake of noncaffeinated liquids should be encouraged: 2 quarts per day of juices or other caloric beverages in frequent, small amounts rather than water alone. Elimination is maintained by administering stool softeners as necessary if analgesic drugs result in constipation.

Using careful, gentle handling techniques, the health care professional assists with range-of-motion exercises, encourages ambulation and mobility as possible, and turns and repositions the immobile patient frequently to decrease the deleterious multisystemic effects of immobilization. Comfort is achieved through correct body alignment, noninvasive measures (e.g., guided imagery and cutaneous stimulation), and prescribed pharmacological measures, preferably administered on a regular schedule to prevent pain, with additional dosing to relieve breakthrough ...