Pain Management among the Elderly and Drug Addicts
Problem
Pain management has remained to be a significant challenge in the healthcare profession. The quality of life of patients with chronic pain is impaired in the absence of proper pain management. The condition of a patient can also deteriorate due to poor management of pain hence the need for nurses to implement strategies that facilitate effective pain management (Abdulla et al, 2013). Pain assessment is always a routine procedure whereby health care professionals grade the pain and prescribe the specific drugs that a patient should take.
The prescription is done despite the variable and special needs of patients such as the elderly and drug users who may not achieve adequate pain management using the standard protocols. Pharmacokinetics, pharmacodynamics, and tolerance to medicines are altered among older persons, and drug addicts hence adequate pain control may not be achieved using the regular practice for the general population (Galanter, Kleber & Brady, 2014). Some hospitals have failed to achieve adequate control of pain for their patients due to failure to customize pain management. The University Hospital, Newark New Jersey can benefit from the implementation of better pain control strategies since most of its patients complain of inadequate pain control.
Intervention
Effective pain management and control among the elderly and drug addicts is based on a comprehensive assessment of the patients. It is vital to obtain a thorough history and physical examination to determine organ impairment among the elderly and risk for drug toxicities. Nurses should also take a comprehensive history to rule out substance abuse for patients in pain so that prescription of pain medication will be tailored to the needs of the patient. The elderly and drug addicts, therefore, need a personalized pain assessment and drug evaluation coiled with interventions tailored to meet their individual needs (Malec & Shega, 2015). The university hospital should adopt a new tool specifically designed for pain evaluation and recognition of risk factors for opioid abuse, drug tolerance, and toxicities among the elderly and the drug addicts.
Comparison
Evaluation will be done on the effectiveness of pain management upon the implementation of the pain assessment tool. The tool is focused on determining the risk for drug tolerance, toxicities and appropriate painkillers to use among the elderly and drug addicts at the university hospital. The results will be compared with pain management at the East Orange General Hospital where the pain assessment tool has not been implemented. Percentage of adequate pain control will be determined for each hospital before and after the intervention to evaluate whether there was a significant change when the unique tool for pain assessment and management was used.
Observation
There is a high likelihood that the number of patients who have achieved adequate pain control at the university hospital will increase with the implementation of the pain assessment and management tool. The introduction of an individualized plan to pain care for patients with chronic pain in the elderly and drug addicts will lead to a better pain control since actions are based on the individual needs of a patient (Peisah et al, 2014). The pain control levels at the East Orange General Hospital might remain the same since the new tool will not be established and strategies of pain control are likely to remain the same. The elderly and drug addicts with a personalized pain management plan in the University Hospital will report better pain control unlike those in the East Orange General Hospital where there is no individual I’d pain assessment and management.
Timeframe
The implementation of a personalized pain evaluation and management tool will be followed by evaluation of pain control in the hospital. The data collection will take two months during which exit questionnaires will be administered to patients on the effectiveness of pain management.
References
Abdulla, A., Adams, N., Bone, M., Elliott, A. M., Gaffin, J., Jones, D., … & Schofield, P. (2013). Guidance on the management of pain in older people. Age and ageing, 42, i1-57.
Galanter, M., Kleber, H. D., & Brady, K. (Eds.). (2014). The American Psychiatric Publishing textbook of substance abuse treatment. American Psychiatric Pub.
Malec, M., & Shega, J. W. (2015). Pain management in the elderly. Medical Clinics, 99(2), 337-350.
Peisah, C., Weaver, J., Wong, L., & Strukovski, J. A. (2014). Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities. Clinical interventions in aging, 9, 1767.
