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EBP essay

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This is an essay I wrote on an EBP for pain management on older adults

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  • September 26, 2024
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SUAREZ 1


Karen Adriana Suarez

Professor Kristen McCreary

Lab

10-07-2023

Pain Management Nursing practice assessment: In older adults with dementia EBP

Pain and dementia are prevalent concerns among older adults, significantly impacting their

quality of life. Chronic pain, particularly in bones and joints, is a common issue, affecting a

substantial percentage of older individuals in Spain, ranging from 25% to as high as 93%

depending on their living situation. Managing pain in older individuals with dementia is

challenging due to their difficulty in recognizing and expressing pain, often manifesting as

behavioral changes mistaken for dementia symptoms. Regrettably, behavioral symptoms may

sometimes be treated with antipsychotic medications instead of pain relief, leading to further

problems like sleep disturbances and reduced physical activity. Effectively monitoring and

managing pain in older dementia patients is crucial for their overall health and well-being.

To ensure effective pain management, pain should be regarded as a vital sign, akin to

blood pressure and heart rate. While the American Pain Society designated pain as the "5th

vital sign" in 1996, this concept is not always put into practice due to inadequate training

among healthcare professionals. For individuals with dementia, a critical step is direct inquiry

about their pain using simple scales when communication is possible, with support from

caregivers. When communication is not feasible, nurses rely on behavioral observation scales

to assess pain. Once pain is identified, it is treated with tailored medications or non-drug

therapies, often complemented by trained professionals like nurses. Post-treatment, pain is

reassessed and documented to monitor progress and evaluate treatment response. Despite

advancements in pain management for dementia patients, limited research has been

conducted on nursing records related to this topic.

, SUAREZ 2


The study in question aimed to assess pain management for older adults with

dementia through a review of electronic health records in an Acute Geriatrics Unit,

investigating the frequency of pain checks, treatment approaches, post-treatment assessments,

and factors influencing pain management.This study focused on dementia patients in a

geriatric unit in a Spanish hospital, specifically those aged 65 and older, admitted between

January and March 2018. The unit specializes in caring for elderly patients with cognitive

impairments and chronic conditions, collecting data on patient demographics, reasons for

hospitalization, and types of dementia. Pain assessment was conducted at least daily,

following the hospital's protocol, with nurses documenting these assessments and adapting

care plans based on the results to ensure patients' well-being.

In the study, nurses used various statistical methods to analyze data, maintaining a

95% confidence level for their results. The study received ethical approval, and patient data

were anonymized for privacy. The research focused on 111 elderly dementia patients, with an

average age of 87, finding connections between factors like gender, reasons for admission,

and pain medication. Nurses assessed pain upon admission and throughout the day, but there

was some variation among shifts. Communication of pain through scales influenced the level

of attention and medication given. Overall, the study suggests a need for standardized pain

management for dementia patients. The results are based on one specific hospital unit and

may not be universally applicable. In conclusion, the study highlights variations in pain

treatment for dementia patients, emphasizing the importance of consistent attention to pain as

a vital sign and exploring the impact of admission reasons and gender on pain medication.

I believe the Clinical study was somewhat ineffective, as no elder adults came into the

study with pain, but about 1% of them came out with pain. I would change the conditions of

the environment that the elder adults were in, as they obviously did not do well in them. I was

surprised that the nightshift nurses checked the elder adult;s pain more than the day shift

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