Pain Management

Role of the Nursing Staff in SGH Pain Management Centre

Tan Choon Yen Nurse Clinician Pain Management Centre JULY 2012

Pain Management Service in SGH

Acute Pain Service

Chronic Pain Service

Pain Management Nursing Over The Years..

Acute Pain Service Chronic Pain Service

ADN Kaldip Kaur First Pain Management Nurse Clinician 1992-1999

Dr Tracy Carol Ayre Director, Nursing

ADN Kaldip Kaur First Pain Management Nurse Clinician 1992-1999

SNM Tan Ai Muay 1999 - 2008

APN Lian Siew Bee Assistant Director, Nursing

NC Tan Choon Yen 2004 onwards

NC Liu Hong Jie 2008 onwards

SEN Nynasoundthri 2007 onwards

PEN Sew Choy Ngor 2008 onwards

SSN Doreen Tan 2006 onwards

SSN Sharifah 2009 onwards

Certifications
PEN Diploma in Nursing

Advanced Diploma in Nursing

Degree in Nursing

SEN

Clinical Attachments In Pain Management

NC Tan Choon Yen Oct Nov 2005

SSN Doreen Tan Jan Feb 2008

NC Liu HongJie Jan 2010

Toronto General Hospital, Canada

We Belong To Professional Bodies

Nurse Clinician Journal Club-SGH

NC Tan Choon Yen

SSN Doreen Tan

NC Liu Hongjie

NC Tan Choon Yen

SSN Doreen Tan

SSN Sharifah

SEN Nynasoundthri

Oncology Chapter

NC Tan Choon Yen SSN Doreen Tan

SSN Doreen Tan

NC Liu Hongjie

SGHs Model of Professional Nursing Practice

Care Delivery Standards of Practice Governance Evidence-based care delivery Core values and ethics

Competence Caring Care Management Ward-based case management Multidisciplinary

Patient

Quality & Safe Care Research Innovation & Improvement Safe staffing Resources Professional development

Patient Care Management

Episodic Care

Acute Care

Chronic Care

Community Care

SGH Pain Initiative: Pain As A Fifth Vital Sign

Launched April 2004 Pain measured

alongside temperature,
BP, heart rate, respiration rate

SGH Pain Assessment Approach

Make Pain the 5th Vital Sign to be assessed for all patients

Use a systematic approach to conduct a comprehensive

assessment if patient is in pain

Educate patient about his pain and how to assess, report and measure pain

Staffing
Outpatient Clinic Consultations 3 consultation rooms multidisciplined

Interventional Procedures

procedure & recovery

Inpatient Referrals ward rounds & patient and family education

Nursing Role: Clinic

Assists and chaperones doctors Assists in the retrieval and preparation of case notes for consultation Assists in designated nursing procedures and treatments, ensuring the general comfort and well-being of the patient. Performs procedure scheduling and financial counselling to patients. Provides patient and family education on the management and care of patients with chronic pain conditions.

Nursing Role: Procedure & Recovery

Participates in preparation of patients for interventional procedures and post procedure monitoring and care. Proficient & dexterous in circulating duties Coordinates the availability of equipment and supplies required for procedures to be performed safely and comfortably.

Nursing Role: Inpatient Ward Round

Participates in developing nursing care plans and discharge planning. Discuss with team on any changes or updates to patient care / patientrelated activities. Provide patient and family education on the management and care of patients with chronic pain conditions.

Nursing Implications
Know your drugs Opioids: Handling and administration

Long acting and short acting

Disposal of

Patient education

Nursing Implications
Pre-procedure preparation Fasting

Medication
Financial counselling Listing Preparing patient for transfer Consent

Documents to prepare
I/V cannula

Nursing Implications
Post-procedure monitoring Comfort

Complications
Neurotoxicity Neurologic Injury Dural Puncture Bleeding

Infection

Nursing Care For Patients on Intrathecal Infusion

Monitoring

ADLs
Care of pump

Care of dressing
Discharge advice

Discharge planning

Management Of PostOp Pain: Pharmacology

PCA

Epidural Analgesia

Nerve Block

Medication

Acute Pain Service Statistics

Nurses as Teachers

Caregiver Training Programme

Advanced Pain Management Programme

Clinical Teaching Round

Workshop On Intrathecal Infusion

Pacing Programme

CBT Programme

Summary
Nurses are committed to delivering safe quality healthcare to the patient in pain Self awareness, knowledge of pain and pain assessment, and knowledge of the standard of care for pain management enhances nurses ability to advocate and ensure effective pain management for each patient

Thank you

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