Minimising pain at wound dressing-related procedures A ... - Less Pain

PRINCIPLES OF
BEST PRACTICE
QUESTIONS TO ASSESS CHARACTER OF PAIN
Does the patient have background and/or incident pain?
Quality:
Describe the pain or soreness in your wound at rest. Is the pain aching or throbbing (likely to be
nociceptive pain) or sharp, burning, or tingling (likely to be neuropathic pain)?
Location:
Where is the pain? Is it limited to the immediate area of the wound or do you feel it in the
surrounding area? Consider using body map
Triggers:
What makes the pain worse? Do touch, pressure, movement, positioning, interventions, day
versus night trigger pain?
Reducers:
What makes the pain better? Do analgesia, bathing, leg elevation etc help to relieve pain?
Does the patient experience pain during or after dressing-related procedures?
Quality:
Describe the pain the last time your dressing was removed
Location:
Where was the pain? Was it limited to the immediate area of the wound or did you feel it in the
surrounding area?
Triggers:
What part of the procedure was most painful, eg dressing removal, cleansing, dressing
application, having the wound exposed?
Reducers:
What helped to reduce the pain, eg time out, slow removal of dressing, removing the dressing
yourself etc?
Timing:
How long did it take for pain to resolve after the procedure?
MEASURE PAIN INTENSITY
Pain scales can record trends in pain intensity before, during and after a procedure and, when
used together with appropriate assessment strategies, provide a broad understanding of the
patient’s pain experience.
!
The simple act of routine pain scoring during dressing-related procedures can impact
significantly on management
PAIN SCALES
Ask the patient to choose a face that best describes how
he/she is feeling
Ask the patient on a scale of 0-10, where 0=no pain and
10=worst possible pain, to choose a number that best
places his/her current level of pain
0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10
Numerical rating scale
Wong-Baker FACES Scale
From Wong DL, Hockenberry-Eaton M, Wilson D, Winklestein ML, Schwartz
P. Wong’s Essentials of Pediatric Nursing (ed 6), St Louis 2001, p 1301.
Copyrighted by Mosby Inc. Reprinted by permission.
Ask the patient to pick a point on the continuum that best
0 reflects how she/he is feeling
10
NO
PAIN
Visual analogue scale
WORST
PAIN
Ask the patient which word best describes his/her
current level of pain
NO MILD MODERATE SEVERE
PAIN PAIN PAIN PAIN
Verbal rating scale
10 | PRINCIPLES OF BEST PRACTICE