guidelinesforassessingpainanddistress：评估疼痛和痛苦的指导方针.doc

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1、NorthSomersetCommunityPartnership"YourLocalHealthSen/ice"A^>NorthWSomersetWorkinginPartnershipJ1councilGuidelinesforAssessingPainandDistress1•Completeabasicneedsassessment,i.e:•Areglasses,denturesorhearingaidsinplaceandfunctional?•Isthepersonhungryorthirs

2、ty?•Doesthepersonhavetoiletneeds?•Isthepersontoohotortoocold?•Aretheyoverstimulated?Ornotenoughstimulation?2.Lookforsignsofdiscomfort,infectionoracuteillness:•Istemperatureraised?•Isheartrateraised?•Rapidbreathing?•Changeinfacialcolouring?•Vomiting?•Change

3、inbowelmovement?(Diarrhoea/constipation)•Changeinurineoutput?•Inflammation(lookforheat,rednessorswelling)Referforamedicalopinioniffeltappropriate・3.Assessforemotionaldistress:•Haveyouaskedtheserviceusertodosomethingthafstoodifficultforthem?•Haveyouaskedthe

4、serviceusertodosomethingthattheydonotwanttodo?•Dotheywantmorestafftime?•Aretheyavoidingbeingwithpeople?•Hastherebeenachangeintheirroutine?•Aretheybored?•Havetheyhadachangeinstaffingrecently?•Havetheyhadanargumentwithafriend/familymember/partnerrecently?•Ha

5、stherebeenanybullyingorabuse?•Havetheycometoanendintheirtherapy?•Hassomeonediedinthelastfewyears?•Havetheywitnessedanincidentrecently?4.Checkmyhistoryinmypainprofile.•Thiswillshowanyknowncausesofpainordistressandhowtheyaregenerallymanaged.•Monitoreffective

6、nessonmonitoringformoverleaf.5.Ifdistressappearstobephysicalpainandcontinues:•IfthereisPRNmedicationwrittenupthenadministerandmonitoreffectivenessonmonitoringformoverleaf.•IfnotprescribedrefertoyourorganisationsHomelyRemediesPolicywhichwillgiveguidanceonad

7、ministeringmedicationincircumstanceswhenitisnotprescribed・•IfPRNmedicationiseffectivebutisstillrequiredformorethan3daysthencontactGPtoreviewandforadvise・•Monitoreffectivenessonmonitoringformoverleaf.2.ConsiderPRNPsychotropicdrugsonlywhenatrialofanalgesicsi

8、snoteffectiveinrelievingdiscomfort(anddifferentdosesordrugshavebeentried).•Remembersomepeopleshowphysicalpainthroughtheirbehaviour.•Monitoreffectivenessonmonitoringformoverleaf.Ifyouareunsureseekadvice・Record