Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
IMPLEMENTATION
PAIN 5TH VITAL SIGN
Implementation Strategies :
1. Supervision
2. Training
3. Resources
4. Working committee at hospital level
5. Change agents
6. Positive Attitude
7. Nursing Audits
8. Internal / external peer review
9. Set & monitor KPIs
10. Competitions & awards
Implementation Strategies :
Monitor for :
• Nurses knows how to pain assessment tool
• Nurses follow flow chart in implementation
• Reassessment for high pain scores.
• Nurses document all nursing actions and
medications served in pain assessment chart.
2. Training : Pain the 5th vital sign
• Must be in included in all orientation programs
for doctors and paramedics. 100% training
* All nurses, sisters and matrons
* All attendants – PPK
* All assistant medical officers – AMO / PPP
* To include pain
assessment in the
nursing curriculum
3. Resources available:
• Training Module
• Flow Chart
• Pain assessment tools available
• Observation forms
• To monitor implementation
7. Increased workload?
• Do not only think of increase in workload
• Practice smartly but no slip-shods / ‘chartology’
8. OTHER IMPORTANT SUGGESTIONS :
gohsk.2016 12
STAFF NURSES ROLES
• Introduce pain assessment tool to patient on
1st pt encounter –
“From today onwards / or from now on …”
gohsk.2009 14
Sample Nursing Observation Chart KKM.JR.PAIN5VS.1/2009
Patient’s Name :
Age : MRN:
Ward :
Diagnosis:
DATE TIME PAIN Nursing action Medication COMMENTS / SIGN
SCORE
29/6/09 8.00 8 Cap.TRAMODAL Throbbing pain /
am (SHOULDER) - 50 mg Gsk
29/6/09 8.30 4 - - Patient
am comfortable / Gsk
29/6/09 12.00 1 - - Pt comfortable /
pm sally
29/6/09 4.00 pm 2 - - Pt comfortable /
susana
29/6/09 8.00 pm 2 - - Pt comfortable /
susana
29/6/09 10.00 pm 6 Cap TRAMODAL 50 mg Pricking /
(SPINE) anna
29/6/09 10.30 pm 3 Positioning – supine, - Pt does not want
Elevate limb with pillow analgesics / Aleez
15
Effective Monitoring of Implementation
The Observation form :
1. Look out for high pain scores – whether any action was taken and
Reassessment for high scores (within 30 mins – 1 hr)
16
gohsk.2009
Frequently Asked Questions
Q. My Pain is a 14.
A. You must be in a lot of pain to choose 14 on a 10
point scale.
gohsk.2009 18
9. Have Competitions and Awards for :
A : Aggravating factors
(What makes the pain worse?)
I : Intensity
gohsk.2009 26
Conclusions
• Pain as the 5th vital sign is necessary to ensure
patients a pleasant and comfortable stay in the
hospital
GSK
1/6/2016
JURURAWAT-
BOLEH !!
gohsk.2009 29
IX. Sharing Tips from Experience,
Video clips & Role Plays