How To Write A Case Control Study

A patient is admitted to Nightingale Community Hospital to the surgical unit following an infection to a post-op wound. There were several deficiencies found on the patient’s tracer audit once the patient was admitted to the hospital. One deficiency that was found was that the patient was given medication related to pain and the patient was not reassessed properly per Joint Commission Standards (JC). The deficiency found is within the pain assessment policy of the hospital.

In the article, “Sometimes Pain Is a Puzzle That Can’t Be Solved”, Abigail Zuger, the author, describes her own experiences with pain along with some examples and generalizations about the feeling. She claims that she is “ruled by (her) elbow” and “it is (her) constant companion, whimpering, and tugging at (her) sleeve.” She goes on to say that many people have the same problems, especially when drugs, “like naproxen and ibuprofen” are unhelpful and “might as well be cornflakes.” Finally, she explains how far we have advanced in the medical field, but “ none of (the) knowledge has translated into new treatments,” to help people such as herself.

The ability to eliminate pain during surgery was a huge medical breakthrough.

Questionable methods of pain relief have been practiced on this planet since the stone ages. Luckily, modern advancements in medicine have granted us safe and quick options for relieving pain. Analgesics, often referred to as painkillers, are drugs that work by targeting the peripheral and central nervous systems. They are important because they are responsible for alleviating our headaches, body aches, fever, and inflammation. Non-opioid analgesics include acetaminophen and non- steroidal inflammatory drugs (NSAIDS) such as aspirin; they are typically used for mild pain.

Patients evaluated in acute pain will often have narcotics withheld until after the patient has been evaluated by a surgeon and has given informed consent. Concern that the patient would have impaired judgment due to narcotic effects often prevents the administration of timely pain relief. Similarly administration of anxiolytics and benzodiazepines are avoided until the patient has consented to the procedure. As there is a considerable heterogeneity in the metabolism of a particular drug depending on age and patient characteristics, there is no specific timeline of how long should one wait prior to getting consent if these medications are given accidentally.

In this crosspost, the author will elaborate on the original threaded discussion by Ellerbee Mburu, Vail, and Barlow and add additional information on pain assessment and management. Healthcare providers are the major group of healthcare professional who perform crucial functions in delivering and providing nursing care to inpatient and outpatients. As mentioned in the threaded discussion by Ellerbee, Mburu, Vail, and Barlow, undertreated pain causes unnecessary distress and negatively affects the quality of life. In additional to the original threaded discussion, pain is a factor that is thought of differently by many. It has been added as the fifth vital sign and is considered to be subjective.

According to a recent study by the Center for Disease Control and Prevention (2016), approximately one individual out of five patients established with a pain-related conditions, is recommended to use opioids for their pain. This practice has continued with time increasing the levels of opioid use among different patients. Medical practitioners have contributed largely to the increase of opioid usage because they are the ones who prescribe these drugs mostly to the patients. However, they have established a major challenge facing them on the prescription of these drugs, as there is a confluence of pain control versus the danger of misuse of such prescriptions. These facts have increased the need to curb this situation before it becomes impossible to deal

Although it may seem easier to the family to push the analgesia for the patient, they must be reminded that the patient is the only one who can truly determine the type and feeling of pain they are experiencing and then have the authority to decide if they need additional medication or

Eula Biss, in her essay “The Pain Scale”, maintains her confusion over the pain scale concept starting from the very first number of the scale and its relevance to the pain itself. She also claims that pain is rather multidimensional process, which I believe is true, and the pain scale cannot provide the base to fully understand the process, thus, I assume, useless. The author in her essay often mentions her father who is a physician and has a lot of experience working with patients. As a doctor he knows how to define and deal with patients `s pain. “Most pain is minor” is one of his statements that disturbed the author and provoked her to create a larger list of pain types.

Doctors can prescribe drugs to help alleviate the pain, but then the drugs also affect the way

CHAPTER TWO LITERATURE REVIEW 2.1. THEORETICAL LITERATURE ON PREOPERATIVE ANXIETY Preoperative anxiety is a challenging in preoperative care of patients awaiting elective surgery and it is widely accepted as an expected response. Anxiety can be explained as a reaction to stress or fear and elicits the autonomic physiological response that helps a person to fight or flight the danger(2). Studies have shown that people react differently to anxiety-provoking situations and related this difference to trait anxiety that described as an established individual difference in anxiety proneness and how stressful situations are perceived have described trait anxiety as a relatively permanent personality characteristic that is not influenced by a

Studies have also showed discrepancies between patient’s and the nursing staff ‘s assessment of pain (Heidrich,Perry,&Amand,1981;Perry,Heidrich, & Ramos,1981; Perry &Heidrich ,1982; Varchol,1983;Walkenstein,1982).Nurses rate pain as less severe than patients rate their pain. Most of the assessment is made from the nurses’ perceptions of pain .However only the person experiencing pain can tell another what it is like.43However, self-reports have two major problems. First, they require the child to have a level of cognitive and linguistic development, which excludes all preverbal children .The second problem is that self-report measures are open to bias because of the demand characteristics of the specific situation.

This writer understands the value of the concept of pain as it is a tool to improve the quality of life. The nurse can manage pain and treat the patient holistically by understanding the concept of pain. This student will continue to provide pain relief by assessing and using nursing knowledge from evidenced based practices in managing

1. Title: A study to assess the ethnic /cultural differences on pain perception among a selected group of orthopedic patients who has underwent Total Knee Replacement (TKR), an improvement project in a General Multispecialty Hospital at Doha – Qatar. 2. Abstract   Working in an ethnically diverse environment means clinicians/nurses regularly come in contact with patients from multicultural societies. The understanding of the concept of pain and the influences of culture or ethnicity on its perception helps in customizing the management of pain among the affected population.

(2013, p.12) emphasised the importance of nursing care for patients after hemicolectomy to promote rapid recovery and quicker discharge from the hospital. They reported that the greatest postoperative complication for hemicolectomy patients is pain management; postoperative patients therefore require scheduled pain management to control severe pain and pain intensity. This may involve both pharmacological and non-pharmacological interventions, as non-pharmacological have been reported to increase the efficacy of pharmacological pain management interventions. Isaacson et al. (2013, p.12) recommended massage, repositioning, ensuring a calm environment and allowing the patient to listen to music.