- Email: [email protected]
The essentials of pain assessment and management
INTENSIVE AND CRITICAL CAFtE NURSING
as underfeeding. Thus, careful consideration of all factors affecting energy expenditure, protein requirements and protein to non-protein calorie ratio is essential. 3. Information collation re factors governing alterations in nutritional needs. The effects of critical illness, activity, body temperature, drugs etc on the patient’s nutritional needs will be discussed. 4. Calculating the patient’s individual requirements. Methods of assessment including anthropometric, biochemical and indirect calorimetry will be discussed with particular reference to their relevance in the critically ill patient. Different methods of nutritional support and access and their benefits and disadvantages will be briefly outlined References Adam S K, Webb A R 1990 Attitudes to the delivery of enteral nutritional support to patients in British intensive care units. Clinical Intensive Care 1: 150-156.
Eesentiahs of wound management Noel LocbyeAtevens Tissue Viability Clinical Specialist, Royal Boumemouth and Christchurch Hospitals NHS Trust, UK This lecture will cover the types of wound a nurse may face in the critical care situation. It will then discuss the relevant factors to the inhibition of wound healing in the same environment. The need for accurate wound assessment and use of a reliable tool that facilitates communication to other staff about a wound’s condition will be discussed. What objectives for treatment should be set and agreed by staff before commencing a dress ing regime and what products may facilitate healing will conclude the lecture.
The essentials of pain assessmentand management
Karen Smith Senior Charge Nurse, Coronary Care Unit and part time Research Fellow, Ninewells Hospital, Dundee, UK The experience of pain is universal in nature, yet unique to the individual. It is one of the commonest reasons for people to seek medical assistance. It is only in tbe last two decades that interest in this fundamental aspect of care has increased, stimulating both research and clinical practice to focus on improving pain relief. It is vital to recognise pain control as a priority and to give this the same emphasis as we do the life-saving treatments and interventions which are common place in critical care areas. The provision of adequate pain management may have particular implications for the critically ill patient thus offering a challenge to nursing and medical staff.
301
Despite the prevalence of literature related to pain and its management, deficits still exist in the management of pain. The essence of caring promotes the desire to relieve pain promptly. This action is essential not only for humanitarian reasons but also since persistent unrelieved pain can initiate deleterious pathophysiological effects which may inhibit optimal recovery. In order to treat pain adequately it is necessary to make a systematic assessment of the patient’s pain. The continuing reasons for the inadequacies which exist in pain assessment will be considered. The behaviour during nurse-patient interactions when patients are in pain will be explored as nursing staff can strongly influence pain assessment and subsequent management. Having attempted to increase the visibility of pain, the implications for education related to pain management will be addressed and the variety of therapeutic interventions which are available to improve pain management in critical care will be considered. Having emphasised the existing deficiencies and considered various pain management strategies, we must encourage critical evaluation of current practice. By such actions we can strive to improve the quality of pain management and reduce the needless suffering which still occurs in many clinical areas.
The essentialsof psychosocial care _ . Julie Pearce Senior Nurse, Research and Practice Development and Senior Research Fellow, Southampton General Hospital/University of Southampton, Southampton, UK Nurses are the key providers of intimate physical care and psychosocial support. This paper sets out to: 1. Outline the impact of critical illness and the environment on the psychosocial, social and emotional wellbeing of the patient and family members. 2. Identify strategies which may be employed which will facilitate assessment of need and planning of care designed to provide psychological and emotional support. 3. Discuss the role of the advanced nurse practitioner and the quality of psychosocial and emotional sup port achieved. 4. Reflect on the nature of caring and the therapeutic potential of the nursing role with regards to meting the psychosocial and emotional needs of the patient and family members.
The dynamics of decisionmaldq~ in clinicalpractice SarahJ Sanford Chief Executive Officer of the American Association of Critical Care Nurses (MCN) Global economic recession, ageing populations and seemingly intractable social and public health dilemmas have combined to create service demands often
as underfeeding. Thus, careful consideration of all factors affecting energy expenditure, protein requirements and protein to non-protein calorie ratio is essential. 3. Information collation re factors governing alterations in nutritional needs. The effects of critical illness, activity, body temperature, drugs etc on the patient’s nutritional needs will be discussed. 4. Calculating the patient’s individual requirements. Methods of assessment including anthropometric, biochemical and indirect calorimetry will be discussed with particular reference to their relevance in the critically ill patient. Different methods of nutritional support and access and their benefits and disadvantages will be briefly outlined References Adam S K, Webb A R 1990 Attitudes to the delivery of enteral nutritional support to patients in British intensive care units. Clinical Intensive Care 1: 150-156.
Eesentiahs of wound management Noel LocbyeAtevens Tissue Viability Clinical Specialist, Royal Boumemouth and Christchurch Hospitals NHS Trust, UK This lecture will cover the types of wound a nurse may face in the critical care situation. It will then discuss the relevant factors to the inhibition of wound healing in the same environment. The need for accurate wound assessment and use of a reliable tool that facilitates communication to other staff about a wound’s condition will be discussed. What objectives for treatment should be set and agreed by staff before commencing a dress ing regime and what products may facilitate healing will conclude the lecture.
The essentials of pain assessmentand management
Karen Smith Senior Charge Nurse, Coronary Care Unit and part time Research Fellow, Ninewells Hospital, Dundee, UK The experience of pain is universal in nature, yet unique to the individual. It is one of the commonest reasons for people to seek medical assistance. It is only in tbe last two decades that interest in this fundamental aspect of care has increased, stimulating both research and clinical practice to focus on improving pain relief. It is vital to recognise pain control as a priority and to give this the same emphasis as we do the life-saving treatments and interventions which are common place in critical care areas. The provision of adequate pain management may have particular implications for the critically ill patient thus offering a challenge to nursing and medical staff.
301
Despite the prevalence of literature related to pain and its management, deficits still exist in the management of pain. The essence of caring promotes the desire to relieve pain promptly. This action is essential not only for humanitarian reasons but also since persistent unrelieved pain can initiate deleterious pathophysiological effects which may inhibit optimal recovery. In order to treat pain adequately it is necessary to make a systematic assessment of the patient’s pain. The continuing reasons for the inadequacies which exist in pain assessment will be considered. The behaviour during nurse-patient interactions when patients are in pain will be explored as nursing staff can strongly influence pain assessment and subsequent management. Having attempted to increase the visibility of pain, the implications for education related to pain management will be addressed and the variety of therapeutic interventions which are available to improve pain management in critical care will be considered. Having emphasised the existing deficiencies and considered various pain management strategies, we must encourage critical evaluation of current practice. By such actions we can strive to improve the quality of pain management and reduce the needless suffering which still occurs in many clinical areas.
The essentialsof psychosocial care _ . Julie Pearce Senior Nurse, Research and Practice Development and Senior Research Fellow, Southampton General Hospital/University of Southampton, Southampton, UK Nurses are the key providers of intimate physical care and psychosocial support. This paper sets out to: 1. Outline the impact of critical illness and the environment on the psychosocial, social and emotional wellbeing of the patient and family members. 2. Identify strategies which may be employed which will facilitate assessment of need and planning of care designed to provide psychological and emotional support. 3. Discuss the role of the advanced nurse practitioner and the quality of psychosocial and emotional sup port achieved. 4. Reflect on the nature of caring and the therapeutic potential of the nursing role with regards to meting the psychosocial and emotional needs of the patient and family members.
The dynamics of decisionmaldq~ in clinicalpractice SarahJ Sanford Chief Executive Officer of the American Association of Critical Care Nurses (MCN) Global economic recession, ageing populations and seemingly intractable social and public health dilemmas have combined to create service demands often