Skill by hedongchenchen


									                   Employee Name:                                                       Date
                   Skill:                Pediatric Pain Assessment and Management
                   Resources / Policy
                   & Procedures
                                         A 10 yr. old female is admitted for abdominal pain. Morphine 1-2
                   Critical Thinking     mg IV is ordered for severe pain. How would you verify that this is
                   Scenario              an appropriate dose? What tools would you use to assess her pain?
                                         Describe how you would assess her.

Skill Components:                                                                    Completion Status
1. Reviews/completes:
        a. Hospital’s Pain management policy
        b. Pediatric medication competency validation
        c. Pain assessment / Management competency validation

2. Verbalizes understanding of appropriate non-verbal scoring tools (ie,
3. Knows location of pediatric medication resource books (pharmacy or nurse’s
4. Verbalizes knowledge of prescribed medication’s action, route of
   administration, drug incompatibilities, adverse reaction and overdose
5. Double checks IV medication dosage with another nurse.
6. Follows hospital PCA medication administration policy (if indicated)
7. Identifies age/developmental factors that influence pain assessment:
       a. Infant:
                 i. Uses crying to indicate pain/discomfort, hunger, frustration
       b. Toddler/Preschooler:
                 i. May not be able to verbalize pain / discomfort
                ii. Concerned about the smallest injury
               iii. Difficult to distinguish crying out of fear vs. pain
       c.. Adolescent: May not want parent present for exams
8. Modifies pain assessment based on child’s age and developmental level
       a. Uses age appropriate pain scales (neonatal, pediatric) to assist in
            determining pain.
       b. Provides age appropriate explanations for child.
       c. Toddler – School age:
            Ask child to point to location of pain / discomfort
            Utilizes props (dolls, teddy bears, etc.) to determine location
       d. Preschool - Adolescence: Uses simple and direct questions.
       e. Adolescence: Provides privacy and respects modesty during exam
9. Closely monitors Vital Signs, respiratory effort, O2 saturation, and LOC
10. Places child on continuous pulse oximetry if IV pain medication is
11. Closely monitor’s and documents child’s level of pain relief /response to pain
    medication or adjunct interventions every 4 hours or more frequently if
12. Provides appropriate adjunctive interventions for comfort and pain relief and
    evaluates effectiveness of interventions.
13. Includes parent participation in physical examination, child’s care and

  Last revised: 7/14/08                        Rural Connection, Inc.                   Pediatrics Checklist
  decision making (age specific)
14. Provide patient/parent education regarding pain management and
    document on patient’s flow chart.
                        Evaluation / Validation Level of              Type of
Self - Assessment                                                                    Comments
                        Methods                     Competency        Validation
Experienced            Verbal Explanation         Beginner         Orientation
Practice Needed        Demonstration              Intermediate     Annual
Not Experienced        Observation                Expert           Other
Not Applicable         Times Completed                              ____________
(based on scope of      Successfully _______
practice)               Practice Exercise
                        Interactive Class

_________________________________             _________________________________
Employee Signature                                   Preceptor Signature

  Last revised: 7/14/08                      Rural Connection, Inc.                  Pediatrics Checklist

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