What are the Key Challenges that Nurses face in accurately assessing Acute Pain in an A & E setting?

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TABLE OF CONTENTS

CRITICAL REVIEW1

Background of the 5 Articles1

Critical Review of the 5 Different Articles2

Evaluation of Research Methods15

REFERENCES19

BIBLIOGRPAHY20

CRITICAL REVIEW

Background of the 5 Articles

For the purpose of this study , a critical review of 5 different studies on pain management has been presented.the 5 different studies are based. All the 5 articles are based on the same theme ie pain management by nurses in emergency departments of different hospital settings.different sorts of comparison and challenges have been mentioned in the articles.the studies mainly highlight the ways through which the nurses over come the pain of the patients in the emergency departments of hospitals. In a study , 'Accuracy of Emergency Nurses in Assessment of Patients' Pain' , a complaint of pain has been cited as a frequent presenting symptom to the Emergency Department (ED), for both adult and pediatric populations. Puntillo and colleagues, (2003) reported pain as chief complaint in more than half of 1,600 medical records reviewed from a one-week period. Retrospective reviews of data from the National Hospital Ambulatory Medical Care Survey identified disparities in pain assessment documentation, particularly in children(Puntillo, Neighbor, O'Neil, Nixon, 2003, pp 171).

In another study , 'Congruence of pain assessment between nurses and emergency department patients: A replication', a review of more than 24,000 ED visits found pain documentation in only 44.5% of cases has been made. Despite knowledge of the need for prompt and accurate triage of children experiencing acute pain, clinical evidence of ongoing disparity in assessment and documentation of pediatric pain has been reported. The assessment and ED response to pain in infants and young pediatric patients has presented challenges. Children and adolescents up to the age of 18 are treated in the Pediatric Emergency Department of many hospitals. Pediatric pain assessment scales have been available for a number of years, however there have also been discrepancies in published reports regarding the age at which these scales provide a valid measure(Duignan, Dunn, 2008, pp 23).

In another study , 'Comparative Study of Methods of Measuring Acute Pain Intensity in an ED' , the age range used to define a pediatric patient has varied according to the information source. American Heart Association guidelines for Pediatric Advanced Life Support and Basic Life Support recommended that health care providers use the age range for children beginning at 1 year old, and up to the beginning of puberty; however this range pertains to physiologic parameters more than pain assessment. This wide variation in age, size, and developmental levels has added to the complexity of pediatric pain management. Consequently, healthcare providers must have a broad knowledge base of assessment, age appropriate pain assessment scales, pain management interventions, and medication dosage ranges(Berthier, Potel, Leconte, Baron ,1998). Published literature indicated an enhanced clinical knowledge base concerning pediatric pain management. A variety of validated pediatric pain assessment tools have been made available for use in the ED and other ...