• Join over 1.2 million students every month
  • Accelerate your learning by 29%
  • Unlimited access from just £6.99 per month

Intensive care of the newborn. IMPLEMENTATION OF A PAIN ASSESSMENT TOOL IN THE NEONATAL INTENSIVE CARE UNIT

Extracts from this document...

Introduction

INTENSIVE CARE OF THE NEWBORN IMPLEMENTATION OF A PAIN ASSESSMENT TOOL IN THE NEONATAL INTENSIVE CARE UNIT CASE STUDY Registration NO: 100252125 Module NO : SNM2137/3114 Unit Leader : Angela Thurlby Word Count : 2058 According to the international association for the study of pain, it is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage (American Academy of paediatrics 2000). In addition, Boxwell (2010) identifies that if newborn pain is not recognised, treated or managed, it can have several short term and long term consequences. Slater et al (2008) suggests that because babies are unable to express the intensity of pain verbally, the assessment of their pain is a complex issue, as it is difficult to measure their pain accurately. As a result, this shortcoming is a major hindrance in providing effective analgesia for babies undergoing neonatal intensive care. It is recommended that nursing and medical staff need to acquire the observational skills necessary to assess the physiological and behavioural cues of the babies to enable them give effective neonatal pain management (Walden M,Gibbins S 2008). They also suggest that the implementation of a pain assessment using a recognised pain assessment tool is necessary. ...read more.

Middle

According to Stevenson et al (2007), the most important behaviour which babies use as a signal of emotional and painful distress is to cry. The baby in the case discussed had behavioural changes each time she was exposed to invasive procedures which was a very reliable indicator of pain. Therefore a tool such as CRIES (Crying, Requiring Oxygen, Increased Vital Signs, Expression, and Sleeplessness), Hogan et al. (1996) would be quite appropriate. However because the technique also involves recording the crying of the baby in order to give a score, this would be difficult to score because the baby in this case was intubated and receiving ventilation. Further, in a different situation, for example, where the baby was not able move, different variables would need to be measured. Therefore there is a need to observe the baby in order to determine which assessment tool would be more effective depending on variables that can be measured. Buttner and Finkew (2001) found that hormonal and metabolic alterations occur when pain is repetitive or persists for hours or days, which compensate the physiological parameters thus making the assessment of pain more difficult. Biochemical measurement of pain includes measuring blood levels of steroids, catecholamine, glucagon, growth hormone, insulin and rennin (Anand et al 2007). ...read more.

Conclusion

These variables were clearly observed and a tool that takes into consideration such variables could be implemented in practice to give accurate assessment of pain. Anand (2006) recommends that more research is needed in to the assessment of pain in the neonatal period. It has also been identified that there is an evidence-practice gap for the assessment and management of pain in neonates even though there is a vast amount of evidence (Gharavi et al 2007; Heaton et al 2007). Therefore in conclusion, training staff to use different tools that measure different variables along with using them more frequently in the NICU will mean that pain assessment tools are both successfully, and accurately implemented, leading to greater effectiveness in identification of pain; which, in the neonatal unit is the most crucial part in providing effective care. If such a tool and techniques had been used for the baby discussed, her pain could have been discovered earlier and managed more effectively. When choosing a pain assessment tool, the clinical value or viability relative to that particular setting should be taken into consideration. This would guarantee compliance among health workers and success in the implementation of a standard pain assessment tool. At the same time further research into more accurate and reliable tools must also be undertaken. ...read more.

The above preview is unformatted text

This student written piece of work is one of many that can be found in our University Degree Nursing section.

Found what you're looking for?

  • Start learning 29% faster today
  • 150,000+ documents available
  • Just £6.99 a month

Not the one? Search for your essay title...
  • Join over 1.2 million students every month
  • Accelerate your learning by 29%
  • Unlimited access from just £6.99 per month

See related essaysSee related essays

Related University Degree Nursing essays

  1. health needs assessment

    There are two Pharmacies in the ward, owned by the same company (no scope for choice), one dentist and one optician (Local NHS 2008). The location of the health centre posses issues as to were it is situated (way back off the main street on an incline).

  2. Reflective account on practice-communication

    Betty was uncertain of her diagnosis and felt that she was being forced to stay at the hospital against her will. By providing her with the information she required, she could understand a purpose for her admission and the decisions being made.

  1. Community Profile

    and condition of the homes can become poor with damp being a detrimental factor. Better Homes for People in Wales (2001) highlights how housing impacts on a populations health and quality of life. Poor housing can lead to an increase in asthma, accidents, anxiety and depression.

  2. Teamwork is an integral part of Accident and Emergency care and if it is ...

    Relatively young and inexperienced medical staff are given the choice to make a critical decision on the degree of chest pain a patient is experiencing. (NSF, 2000) Arrangements for assessments and treatment of the patient's acute chest pain are made; this includes the eligibility for the thrombolysis treatment or heparin.

  1. HOSPITAL CASE ANALYSIS. This case study takes place at a hospital and is based ...

    As a result, supplies are not prepared in advance and patient visits request not always went promptly. Also, Rogers does not do check ups on her subordinates regularly. A possible factor causing the poor organization is that Rogers makes a perceptual distortion, or self- fulfilling prophecy to be exact.

  2. This assignment is a client-focused study based on the four stage nursing process- assessment, ...

    Why though, do we assess? The purpose of assessment is manifold but is essentially undertaken to identify risk and highlight general problem areas in order to provide a platform for possible future intervention (Hinchliff et al, 1998). Assessment should be comprehensive and cover the biological, psychological and social spheres of an individual's life.

  1. Ulcerative colitis. The young gentleman I took part in his care had an ...

    An arrangement was made to make a family member come and stay with him in the hospital and as such stress associated with social isolation was reduced. The care involved the observation of the stool character as well as the number, the auscultation of the bowel sounds, weight monitoring, and establishment of the nutrition intake and output.

  2. The focus of this assignment will be on a case scenario of an elderly ...

    Her GP made a referral to the community nursing team to assess the wound and to discuss the plan of care. In order to effectively manage this condition an assessment is essential to determine her general health and her history (RCN 2006), this is necessary to help identify the type of ulcer that is present.

  • Over 160,000 pieces
    of student written work
  • Annotated by
    experienced teachers
  • Ideas and feedback to
    improve your own work