Which Tools Are Best When Assessing Pain in Dementia Patients

Introduction

In any healthcare facility, nurses are always at the forefront for the patient care. They ensure there is convey of pertinent information between them and the patient as well as to the doctors. Most healthcare organizations utilize the theoretical framework of the data-information-knowledge-wisdom continuum (DIKW) to make them understand the medical information systems and their impact on healthcare. American Nurses Association assert that "nursing informatics is the specialty that integrates nursing science with multiple information and analytical sciences to identify, define, manage, and communicate DIKW in nursing practice" (2014). Therefore, in all areas of practices, DIKW is of great value to nurses as it gives them the capability of searching databases and retrieving relevant information for use in practice. The paper, therefore, explores a research question relevant to my practice and work on its progression of DIKW continuum.

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Clinical Question

The research question is; which tools are best when assessing pain in dementia patients? The goal of any hospital is to enhance life quality to individuals with fatal prognosis by treating pain and symptoms. In every visit, nurses are obligated to evaluate pain in dementia patients and those that are not capable of communicating effectively. There are various tools that can be used in assessing pain in patients and to answer the research question, DIKW conceptual framework will be followed.

Data-McGonigle and Mastrian assert that "data are discrete entities described objectively without interpretation" (2015). Data need to be looked at in an elemental way and collected at the most basic level. In the case, every single piece of information concerning the diagnosis, weight or age of the patient needs to be obtained and recorded. By utilizing the Walden library, data were obtained for dementia disease, its pain and also its tools of assessment pain.

Information- this is any data with meaning and by utilizing the Walden Library, the research was able to include research articles both scholarly and peer-reviewed over the past five years. The articles used, assessed the observational pain in patients with dementia disease.

Knowledge- here, information is read through the available information and gives responses to 'Why' and 'How' questions of the problem. The clustered information formulates the best tools for pain assessment and the reason why.

Wisdom- McGonigle and Mastrian (2015) approve that wisdom applies the knowledge that is acquired in the practice. To have the best results, pain is identified and assessed on what it has shown in the research in the dementia patients and then the assessment is used when required.

Databases and Search Words

CINAHL Plus with Full Text and Systemic Reviews of Cochrane Database were used in narrowing down all the data in the Walden Library that pertain to the research. Articles with a higher level of evidence-based practice were obtained from the Cochrane Database. Key and search words of the subject that were utilized interchangeably and helped in further narrowing the results of information include dementia, assessment, and pain assessment.

Useable Knowledge

It was through reading information from distinct types of studies that useable knowledge was gained. From the studies, a conclusion was made that management of pain in older individuals was undertreated as a result of nurses not recognizing the symptoms of pain. Patients can display pain in another form especially when they are unable to verbally tell the nurses where they are experiencing the pain. Cognitive behaviors including the aggression and agitation are likely to occur to patients with dementia which may lead to wrong medication of antipsychotic (Lichtner et.al. 2014). In the comprehensive observational assessment of pain, the American Geriatrics Society (AGS) recommends six behavioral domains. They include; "facial expression, Verbalizations, body movements, mental status changes, changes in interpersonal interactions and changes in activity patterns or routines (Hadjistavropoulos, Fitzgerald & Marchildon, 2010). Even though there is no gold-standard for observing pain in dementia patients, using the six behavioral domains will help nurses to assess such patients especially those that are unable to communicate.

Knowledge to Wisdom

Nurses need to apply this in their practice so as to be able to move from knowledge gained from information to wisdom. Since pain is a factor for dementia patients, there is the need for thorough investigations to those that are unable to communicate effectively. The six behavioral domains should be utilized in their practice as recommended by the AGS. Also, to those that are unable to provide valuable information, it is significant that their history and physical appearance be reviewed for the sake of getting to know the patient better and be able to help them effectively.

Summary

From the study above, it is clear that for nurses to make effective decisions and enhance patient care, they must utilize the data- information- knowledge- wisdom Continuum in their practice. It is information technology that enables nurses to collect all data and assist them in developing it into information followed by knowledge and wisdom hence implementing the best practice in healthcare. Implementation of better care and improvement of the population can only be accomplished if they have all this information at their fingerprints.

References

American Nurses Association. (2015). Nursing's social policy statement: The essence of the profession. Nursesbooks. org.

Hadjistavropoulos, T., Fitzgerald, T. D., & Marchildon, G. P. (2010). Practice guidelines for assessing pain in older persons with dementia residing in long-term care facilities. Physiotherapy Canada, 62(2), 104-113.

Lichtner, V., Dowding, D., Esterhuizen, P., Closs, S. J., Long, A. F., Corbett, A., & Briggs, M. (2014). Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools. BMC Geriatrics, 14(1), 138.

McGonigle, D., & Mastrian, K. (2014). Nursing informatics and the foundation of knowledge. Jones & Bartlett Publishers.