Chronic Pain - Nursing Assessment and Management Made Easy
A 2 Day Seminar for all Nurses
Chronic pain is difficult to manage well but with proper knowledge and application good outcomes for the patient can be achieved. Attend this seminar and learn about:
- What causes chronic pain and how it differs to acute pain
- Why is pain a unique experience
- How to effectively assess a person with chronic pain
- Nursing strategies for minimising chronic pain
- Using opioids judiciously
- Non-medicine interventions that work
- Case scenarios to practice putting it all together
Need for Program
Chronic pain affects many people in the community; is a major clinical challenge and a common reason for people to visit their GP. Often chronic pain is unable to be cured. Because pain is a multidimensional, unique experience, treatments and nursing care may vary considerably. Knowing and using today’s best evidence in the assessment and management of a person with chronic pain will result in improved function and well-being and lessen the high cost of care for all concerned.
Purpose of Program
The purpose of this seminar is to provide nurses with knowledge relating to chronic pain and evidence-based management strategies to improve care for people with persistent and advanced pain.
At the conclusion of this program it is expected that the participants will be able to:
- Be able to differentiate between types of pain and how their symptoms manifest in an individual
- Patients in your care will receive a comprehensive assessment to determine: the nature, the experience and the impacts of the pain
- Discriminate between a range of therapies to ensure that the patient receives care that is aligned with The National Pain Strategy Guidelines
- Formulate a nursing care plan for a person with chronic pain, evaluate the outcome and, revise the plan as needed
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8:30am - Registration and Refreshments
Why Pain is a Unique Experience for Each Person
What is pain? It is such a broad term and means different things to different people. The pain experience depends on so many factors - the person, their state of mind, their past experiences, the disease and so on. This introductory session looks at the role that pain plays in our society and how it influences health and well-being and longevity for individuals. Includes:
- Why pain matters
- Fears and anxieties: the psychological impact of pain on different people
- The loneliness and subjectivity of pain
- What are the consequences of untreated chronic pain for the person?
The Different Types of Pain and Their Causes
Chronic pain results from a wide variety of conditions, diseases and injuries. How does chronic pain differ from acute pain? This session reviews the aetiology and pathophysiology of chronic pain. Includes:
- Does it throb, stab or ache? - Understanding the different types of pain:
- Pain mechanisms and pathways, including sensitising or modulating factors
10:30am - Morning Tea and Coffee
Interpreting Signs and Symptoms of Pain
This session extends the previous session by looking at the relationship between disease and chronic pain. It reviews:
- What common signs and symptoms are associated with chronic pain e.g. numbness; increased heart rate; change in behaviour
- Pain thresholds in different individuals
- What about ‘referred’ pain?
Nursing Assessment of Pain – Part 1 - Not Just ‘The Hurt’
The multidimensional experience of pain obviously causes people to interpret and respond to pain in a unique manner. This session sets the scene for performing a comprehensive assessment and includes:
- How our own bias and expectations can affect assessment
- Taking into account the social, emotional, psychological and spiritual factors of the person
- Age and gender considerations
- Cognitive decline and communicating pain
- Cultural considerations - e.g. stoicism and language barriers
1:00pm - Lunch Break and Networking
Nursing Assessment of Pain - Part 2 - Objective Assessment
A look at validated pain assessment tools and mnemonics (such as OPQRST) to assist in framing the characteristics of pain. Includes:
- Which assessment tools are more likely to result in a comprehensive pain assessment?
- Assessing a person’s pain duration, severity, location and threshold?
- Pain and dermatomes
- How is persistent pain affecting the activities of daily living?
- Diagnostic tests e.g. MRI scans
- Documenting your assessment findings, including reports to other members of the multi-disciplinary team
3:00pm - Afternoon Tea and Coffee
Translating Assessment in Goals of Care
This final session of day one will involve small group nursing case scenarios to be workshopped, to identify which tools to use and what to look for when performing a pain assessment for these various conditions. Principles of setting realistic goals that can be readily implemented and measured will be included. Case scenarios and group work to discuss:
- Lower back pain e.g. musculoskeletal pain
- Arthritis and osteoarthritis e.g. inflammatory pain
- Neuropathies e.g. diabetic neuropathy
- Post-herpetic neuralgia e.g. shingles
- A person with cognitive decline
4:15pm - Close of Day One of Program
9:00am - Commencement of Day Two
National Pain Strategy Guidelines
This brief session looks at aligning the Australian National Pain Strategy Guidelines. It emphasises the importance of treating the underlying cause of the pain as well as the symptoms.
Nursing Patients with Advanced Cancer Pain
Advanced cancer is often associated with pain. Managing this type of pain can be a challenge. However, pain management in such circumstance is possible. This session will review your knowledge of the following:
- Overview of cancer pain terminology
- Incidence in patients with advanced cancer – one pain or many - a review of common types and symptoms of cancer pain?
- Setting goals when pain appears intractable
- Advocating for the patient when intervention is not working
10:30am - Morning Tea and Coffee
Analgesics and other Medicines for Chronic Pain
Analgesics take many forms and have varied modes and durations of action. This session will provide an opportunity to refresh your knowledge of a range of analgesics and other medications that may be prescribed for reducing pain, including:
- Ointment, patch, tablet or infusion? Deciding which form of analgesia to administer and comments about the common side effects or complications
- What is a co-analgesic or opioid-sparing analgesic?
- What is meant by the term 'therapeutic window'?
The Judicious Use of Opioids - Implications for Nursing Practice
Because opioids are used widely in pain management yet their potential for harm and misuse is ever present, it is essential that these medicines are fully understood and appropriately used so nurses can confidently feel safe administering them. This session offers an in depth review of opioid medications including:
- Methods of administration
- Dose titration
- Equianalgesic dosing
- Management of opioid induced side effects e.g. constipation; falls etc.
- Dosing considerations in the elderly
- Identifying tolerance
- Preventing dependency
- Identifying drug diversion and other inappropriate behaviours
12:30pm - Lunch Break and Networking
Other Pain Management Options
The following two sessions consider a broad range of options for patients, which nurses can include in patient-education, implement or recommend.
Part 1 - Commonly Used Therapies
- Heat e.g. wheat bags and that packs
- Massage and tactile techniques
- Complementary and alternative therapies
- Relaxation and distraction techniques
- Management of impaired sleep
- Cognitive behavioural therapy and support groups
Part 2 - Interventional Therapies
- Pain management devices and implantable therapies e.g. TENS machines
- Interventional procedures, blocks, infusions and other treatments
3:00pm - Afternoon Tea and Coffee
Nursing Case Scenarios to Consolidate Your Learning
The nurse's role in pain management and the importance of the relationship between the nurse, the patient and their family will be highlighted in the following small group nursing case scenarios. In this final session you will consulate your learning by applying assessment and management practices to the following:
- Prostate cancer – e.g. bone, bowel and bladder related pains
- Lung cancer – e.g. brain, bone and nerve plexus related pains
- Breast cancer – e.g. bone, brain and liver related pains
4:00pm - Close of Seminar and Evaluations