002 How Painful is Wound Care?

Abstract

This study examined adult hospitalized patients’ responses to wound care pain and its treatment. Wound care included dressing change, packing, irrigation, and debridement. The subjective experience of pain intensity was measured with a numeric rating scale (NRS) prior to, immediately after, and 10 minutes after completion of the procedure. The sample was composed of 412 subjects. Most were male (52.3%), white (73.9%), had one wound (59.5%), and had undergone surgery (73.9%). When pain intensity was compared over time, pain intensity was greatest (NRS 4.4, SD 3.2) during the procedure (p < .023), and nonsurgical patients experienced significantly greater pain than surgical patients (p = .002)(NRS 5.3, SD 3.0, NRS 4.1, SD3.2, respectively). Most patients underwent multiple wound care procedures. When the pain intensity of undergoing only a dressing change (n = 61), only packing (n = 41), or ≥2 procedures (n = 258) was examined by whether subjects had undergone surgery or no surgery, nonsurgical patients reported greater pain intensity with dressing change (p < .001) and ≥2 procedures (p < .001). Few subjects received analgesics (7.3% surgical patients 5.9% nonsurgical); there was no difference by group in the amount of opioid administered (p = .821). Sedatives and NSAIDS were rarely used. Treatment with pain medication was examined over time. Those with least pain received significantly less pain medication when compared with those who received premedication only and those who received medication prior to and during the procedure (p < .05). Findings show wound care is painful and wound care pain is undertreated. Further research is needed to address the effect of pain on wound-related patient outcomes and strategies to minimize pain. Acknowledgment: Funded by the AACN, K. Puntillo, PI