Myth of opioid
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Myth of opioid Myth of opioid Presentation Transcript

  • MYTH of OPIOID
  • Fact or Myth People who take pain medication (opioids) generally become addicted.
  • MYTH Less then 1 percent of those who take opioids for pain become addicted.
  • Fact or Myth Elders tend to report more pain as they age.
  • MYTH Many elders tend to not report their pain because they think it is a natural part of growing older.
  • Fact or Myth Opioids should not be considered when treating elders with severe pain.
  • MYTH Opioids are the first line of defense we have to combat severe pain. Opioids have no maximum daily dose.This allows us to adjust dose to effective level, no matter how severe.
  • Fact or Myth Effective pain control improves the ability to fight disease.
  • FACT One side effect of unrelieved pain is a compromised immune system.
  • Fact or Myth Constipation is a manageable side effect of opioid use.
  • A bowel program must always be initiated with opioid use. FACT
  • True or False Communication is a key component in good pain management.
  • Communication must occur between all persons/departments. TRUE
  • Name three reasons why families or caregivers may not recognize or believe elders’ reports of pain.
  • • Fear of addiction • Culture • Fear of side effects • Don’t want loved one to be “targeted or labeled” • Knowledge deficit
  • Name three barriers to good pain management by health care providers.
  • • Personal biases • Inadequate pain assessment skills • Lack of knowledge • Lack of time • Fear of patient addiction
  • Name three barriers to good pain management by physicians.
  • • Fear of legal issues • Fear of regulatory scrutiny • Unfamiliarity with opioids • Fear of patient addiction • Concern about detrimental side effects • Lack of communication by health care personnel and the patient/family
  • Give three reasons elders may not report pain.
  • • Worry about cost • Fear of addiction • Fear of losing independence • Don’t want to be a bother • Culture • Fear of side effects • Cognitively Impaired • Depression • Low expectations for pain relief
  • True or False A person’s pain is whatever they say it is and exists whenever they say it does.
  • This is the definition advocated by Margo McCaffery and is subscribed to by many pain management programs. TRUE
  • Give three signs of pain that might be exhibited by cognitively impaired elders.
  •  Changes in emotion (tears)  Changes in movement (restlessness)  Verbal cues (whimpering, screaming)  Facial cues (grimacing)  Changes in body position (guarding)
  • What doesWILDA stand for?
  • Words to describe pain Intensity of the pain Location of the pain Duration of pain Aggravating/Alleviating factors
  • What words might a person use to describe Neuropathic pain?
  • • Shooting • Stabbing • Burning • Tingling • Numbness • Radiating
  • What words might a person use to describe Somatic and/orVisceral pain?
  • Somatic – aching, throbbing, gnawing Viceral – cramping, pressure, deep aching, referred
  • True or False Pain medication can not be administered to a person unless they ask for it.
  • Staff and family should recognize signs/symptoms of pain in individuals and speak on their behalf. FALSE
  • True or False Nursing is the only discipline that needs to be educated on pain.
  • All health care workers are part of the team responsible for providing effective pain management. FALSE
  • Name three different non- pharmacological interventions.
  •  Massage  Heat/Cold  Relaxation/ Imagery  Distraction  Pastoral Consult  Exercise  Immobilization  TENS (transcutaneous electrical nerve stimulation)  Acupuncture  Hypnosis
  • How often should the nurse complete a comprehensive pain assessment?
  •  Admission/Readmission  Change in pain status or health status  Each Minimum Data Set/ Outcome and Assessment Information Set (MDS/OASIS) Assessment
  • Name three things to educate the elder and family about when implementing opioids or pain management.
  •  Benefits of effective pain management  Options available  Goal of treatment  Side Effects and their treatment (bowels!)  Cost  Negative effects of pain  Pain symptoms – including nonverbal
  • True or False The elderly usually have at least three different sites of pain.
  • And it is important to assess each pain site separately and document according to WILDA criteria. TRUE
  • List at least three differences between acute and chronic pain.
  •  Acute Pain  Short term  Sudden onset  Usually known cause  Usually goes away  Typically doesn’t cause severe emotional stress  Chronic Pain  Often unknown cause/onset  Causes depression, sadness, anxiety, anger, loss of control  May continue throughout life and requires comprehensive treatment
  • What are some non- pharmacological interventions that the departments other than nursing can do?
  •  Involve in activities  1:1 room visits  Aromatherapy  Touch – massage, lotion  Take on walks  Read  Support groups
  • What can administration do to support effective pain management?
  •  Effective policies  Adequate supplies  Training/education programs
  • What does theWHO Ladder stand for and how is it used?
  •  World Health Organization ▪ Systematic approach to treat mild, moderate and severe pain
  • Jeopardy Game Template adapted from the work of Susan Collins and Eleanor Savko, District Resource Teachers for Hardin County Schools: www.hardin.k12.ky.us/res_techn/sbjarea/math/MathJeopardy.htm This material was prepared by the New Mexico Medical Review Association (NMMRA), the Medicare Quality Improvement Organization for New Mexico, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. It is based on material produced by the Kansas Foundation for Medical Care. The contents presented do not necessarily reflect CMS policy. 9SOW-NM-PS-08-36
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