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The assessment and management of postoperative pain: Nursing considerations

The assessment and management of postoperative pain: Nursing considerations

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An essay for the 2011 Undergraduate Awards (Lecturer Nomination) Competition by marie dollard. It is nominated by Lecturer declan patton of University College Dublin in the category of Nursing & Midwifery
An essay for the 2011 Undergraduate Awards (Lecturer Nomination) Competition by marie dollard. It is nominated by Lecturer declan patton of University College Dublin in the category of Nursing & Midwifery

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Published by: Undergraduate Awards on Sep 01, 2012
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Assignment Title: ‘The Assessment and Management of Postoperative Pain:Nursing Considerations’.Introduction:
The focus of this literature review is to examine nursing considerations in theassessment and management of pain in postoperative patients. Pain can be defined as‘an unpleasant sensation ranging from mild discomfort to agonizing distress,associated with real or potential tissue damage’ (McFerran and Martin 2008:363).Despite the improvement in the management and assessment of postoperative painover the years, the quality of postoperative pain is still inadequate (Gordon et al2002). This is also the case in children’s nursing (Twycross 2007) as children are stillexperiencing moderate to severe unalleviated pain post operatively (Johnston et al2005). Thus, this literature review has clear implications for nursing. The focus of thisauthor’s literature has changed slightly from December’s essay which embraced ‘the1
nurses’ role in the assessment and management of wound related pain’. The reason for the change was due to the lack of research regarding pain specifically related towounds. It is clear that more research is needed in this area. This author used multiplesearch engines to access relevant articles. These search engines included Cinahl,PubMed and Cochrane library. This author also spoke to Clinical Nurse Specialist,clinical placement co-ordinators and personal tutor to facilitate in developing thisauthors idea into a question and to ensure correct search terms were being used.Limitations in the search engines included research based articles; peer reviewed,within the last five years. The reasons this author chose this topic was both because of interest in this topic and personal experience. This essay will be based on ten keyarticles selected by the author. However this author will also draw upon other literature and clinical experiences to support the findings. The following are the tenkey articles that will be focused on:Dihle et al (2006),Sloman et al (2005),Simons and Moseley (2008),He et al (2005),Ranjit and Manias (2010),Ene et al (2008),Idvall et al (2008),Rejeh et al (2009),Brown and McCormack (2006),Twycross (2008).2
Aims/Objectives and Background:
Each of the ten articles had a research aims that related to pain in postoperative patients and nursing practice. Two of the four paediatric nursing articles had differentaims. Simons and Moseley (2008) aim was focused an analgesia and the difference inwhat children are prescribed and what they are administered postoperatively and toinvestigate the impact of an analgesia being prescribed regularly or ‘as required’.Whereas He et al (2005), objective was to study Chinese nurses’ use of non- pharmacological interventions for post operative pain relief. However the tworemaining paediatric articles were similar. Twycross (2008) aim was look at thequality of nurses’ pain management and to ascertain whether there was a connection between nurses’ practices and their perceived importance of pain management.Equally, Ranjit and Manias (2010) aim was to examine paediatric nurses’ painassessment and management practices in post operative children. Also Brown andMcCormack (2006) looked at nursing practices. Congruently Idvall (2008) aim was toassess patients’ perspectives of post operative pain management. Rejeh et al (2009)and Dihle et al (2006) had related aims to explore the barriers to effective postoperative pain. Sloman et al (2005) aimed to compare nurses’ and patients painratings and to see if they were influenced by cultural differences. Like Sloman et al(2005), Ene et al (2008) wanted to compare patients and nurses ratings but to whatextent the amount of opioids given correlate with pain levels. Although each of theaims was answered, results would have been strengthened in some articles for example with focus on a bigger sample size which will be addressed later in the essay.All the articles have similar backgrounds. Mainly each study was carried out because3

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