Pilot Project: The Chronic Pain Diary Student: Hetal Patel Nurs 260 Semester – II Teacher: Mary McGrory March 17, 2009 Article evaluation The nursing journal “Pilot Project: The Chronic Pain Diary” is an assessment of chronic pain in the Nursing home population. The author of this journal is Dr. Kathy K Hager and Dr. Dorothy Brockopp.
Dr. Hager is an Assistant Professor of Nursing in Bellarmine University Lansing School of Nursing from Louisville – Kentucky and Dr. Brockopp is an Associated Dean for Academic Affairs in University of Kentucky College of Nursing from Lexington – Kentucky.The author has assessed the chronic pain in nursing home resident fourteen days before and after the use of self report diary.
The data findings show that there is significant increase in the pain levels, pain – related nursing entries, need for the schedule and prn medications. As per American Geriatrics Society, 2002 (pS205), a chronic pain is defined as a painful experience that continues for a longer period of time that may or may not be associated with a recognizable disease process.In nursing home residents, the rate of chronic pain varies from 45% to 83% and it depends on individuals; their mental status, demographic data (gender, age, nationality), and stoicism; the types of questions asked and assessment methods; their willingness to report and reasons to participates. In older adults pain significantly increases with age and conditions that are associated with pain are arthritis, bone and joint disorders, and back problems.As per Castle and Engberg, 2006 the nursing homes have been identified with high turnover rate which resulted in increased faculties costs, low staffing levels and job satisfaction and overall lower quality of life for residents.
Therefore, continuous staff education is important for improvement of pain. Also, increased used of scheduled and as needed medication, and decreased use of expensive medication, treatment, and procedure requires for improvement of refractory chronic pain.Lack of trust in documentation of care givers, including physicians, RNs, RPSs, nurse aides, and family caregiver, contribute to assessing and managing chronic pain (Ferrell, Ferrell, and Osterweil, 1990). Research on diaries used in individuals for chronic pain, cancer – related pain, and palliative care which conclude that pain diary is a valid and reliable source for pain assessment.
The most important advantage of using diary is the abilities of nursing home resident to report their pain at the time the pain is experienced.Recall based and retrospective assessment of chronic pain is depends on the nursing home resident’s memory about reporting a pain event which distorted over the time (Roelofs, Peters, Patijn, Schouten, and Vlaeyen, 2004). The Pilot project carried out to determine whether recording pain in the diary is associated with change in chronic pain levels, nursing documentations, and medication use. The study conducted during six weeks periods in which data collected two weeks prior to use of diary.The diary was used for two weeks and data collected after two weeks of use of diary. The study was conducted at one hundred thirty beds with twenty five nurses and seventy five nursing aides.
Also, twenty dietary staff, twelve housekeeping staff, five maintenance staff, two social services staff, six activities directors, and ten therapists such physical, retroactive, speech, and occupational. Reference American Geriatrics Society Panel on Persistent Pain in Older Persons (2002), Journal of the American Geriatrics Society, 50 (Suppl. 6) S205 – S224.
