Frequency
True or False:
As a preceptor, I should check my orientee's pain documentation throughout the shift
True- you should help set their routine, documentation, and standard of practice up for success early on and correct practice early
True or False:
Documenting a narcotic administration to a patient starts the 60 minute reassessment clock
True- if a reassessment is not documented within the hour, you are deemed non-compliant in your pain reassessment.
Your Orientee asks you how to determine how much medication the patient has had over the past 24 hours, where do you point them to look?
Morphine Equivalent Daily Dose (MEDD)
A pain assessment should be documented at what frequency
Q4H minimal, with every new report of pain, and within 60 minutes of a pain intervention
True or False
Documenting ice applied will start the 60 minute reassessment clock?
True- even non-pharmacological measures require a reassessment to show that pain was managed properly
True or False:
The MEDD helps you identify a patient's risk of overdose/ respiratory depression
True- >50/day doubles the risk of respiratory depression related to narcotics
Your Orientee asks how often a Comprehensive pain assessment must be documented, what is your response?
With every new report of pain that has not been previously documented
What is the minimal documentation required for a pain reassessment in order to stop the clock/be compliant?
1- Pain score
2- Response to relief measure
Your orientee asks what the difference is between opioid tolerant and opioid naive. How do you respond?
Opioid tolerant: patients who are taking, for 1 week or longer, at least: 60 mg oral morphine/day
Norco is administered at 1658 for a pain level of 8/10. When is my reassessment due to stay compliant?
1757- reassessment should be WITHIN 60 minutes, so documentation should occur in 59 minutes or less.
Your orientee documents a relief measure in the same column as their reassessment from another intervention, will this restart the clock?
Yes- anytime you document a relief measure/intervention the clock is restarted
A patient is asking your orientee to give more narcotics than they are comfortable with (2 pills instead of 1 with the range order of 1-2 tabs Q4), How can you coach your orientee to communicate with the patient?
Show them the MEDD and explain to the patient that >50/day doubles their risk of respiratory depression. You can add easier than taking away
Consider multimodal therapy to decrease the need for opioids and treat pain more effectively