This document outlines a pain management course that teaches students to assess and manage pain in residents. The course objectives are to identify ways to assess pain in cognitively impaired and alert residents, evaluate pain using scales, assess and set pain goals upon admission, recognize pain signs and symptoms, implement pain interventions, and improve resident satisfaction through pain management. Students will learn to assess chronic and acute pain, use non-pharmacological and pharmacological pain interventions, document pain assessments and treatments, and evaluate pain management effectiveness. The course covers pain diagnosis, factors, scales, and managing pain through various treatments and ensuring resident comfort.

1. PAIN MANAGEMENT
Barbara Spear
Kaplan University
April 3, 2012

2. COURSE OBJECTIVES
 The student will identify ways to assess and document
pain in the cognitively impaired resident.
 The student will identify ways to assess and document in
the alert and oriented resident.
 The student will evaluate effectiveness of pain
management by utilizing a pain scale.

3. LEARNING OBJECTIVES
By the end of the course the student will be able to:
 Assess and obtain a pain goal upon admission.
 Recognize signs and symptoms of pain.
 Implement interventions to decrease pain levels.
 Manage pain.
 Improve resident satisfaction through pain management.

4. TECHNOLOGIES
 Email power point presentation prior to webinar.
 Webinar for conference with guest speaker.
 On line research to support the data.
 Lab simulation inserted into power point presentation

5. PAIN IS…
 Chronic (obtain the history).
 Acute (why admitted?).
 Perception of the resident (varying ability to endure pain).
 Disease related (Neuropathy, CVA, Osteoporosis…).
 Physical and emotional stressor (newly admitted, chronic
depression…).

6. FACTORS
 Culture and traditions (alternative medicines, non medical,
spiritual…)
 History (chronic disease, trauma…).
 Condition emotionally and physically (depression, stress,
anxiety…).
 Age related (Osteoporosis, decreased mobility…)
 Cognition related (dementia/behaviors, decreased activity…).

7. COGNITIVELY IMPAIRED
 Unable to communicate needs (review records,
interventions identified…).
 Unable to reposition frequently (schedule repositioning,
care plans…).
 Poor nutrition (intake/output records, weights, medical
review…)
 Depression (referrals).

8. DIAGNOSIS
 X-ray (baseline)
 Disease process (know the history!).
 Positional (interventions, referrals, schedules…).
 Further intervention versus comfort care (medical review,
family meetings).
 Team approach (social worker, nurse, aid, educator…).

9. PAIN ASSESSMENT
 Goal upon admission (varying pain tolerance).
 Signs (facial grimace, body position, vocal, behaviors,
 Symptoms (nausea, depression, descriptors).
 History
 Chronic versus acute
 SCALES!! (questionnaires, audit, tools, interview…).

10. PAIN SCALE

11. PAIN MANAGEMENT
 Symptoms
 Medication
 Non-medication relief (rehab consults)
 Control (interview and assessment)
 Care plans with interventions

12. NON-PHARMACOLOGICAL
 Reposition
 Rehab consult for Physical or Occupational Therapy
 Socialization
 Hand to hand contact
 Heat cold or alternative
 Meditation

13. PAIN DOCUMENTATION
 Flow sheets
 Care plans
 MAR and TAR’s
 Progress notes with interventions
 Review staff reports
 Ongoing education for either discharge or maintenance for
LTC resident.

14. RESIDENT SATISFACTION
 Did the intervention work?
 What worked?
 Medication review
 PRN versus a standing order to be more effective?

15. OVERVIEW
 Obtain a goal for pain upon admission!
 Assess, intervene and document pain relief measures.
 Is the pain intervention working?
 Scales!
 Is the resident comfortable, improved quality of life?
 Any questions?

16. REFERENCES
Billings, D. M., & Halstead, J. A. (2009). Teaching in nursing: A guide for faculty. St. Louis, MO:
Saunders Elsevier.
Oermann, M. H., & Gaberson, K. B. (2009). Evaluation and testing in nursing education. New
York, NY: Springer.