444 Pain Assessment Disparities Among Residents and Nurses

Abstract

Accurate pain assessment is important to adequately treat pain. Current and widely used method to measure pain involves numeric rating scale (NRS) in which patients state their pain on a scale of 0–10. However, NRS can lead to subjective interpretation and treatment of pain. We hypothesize that the interpretation and treatment of pain score will vary between nurses and resident physicians. We conducted a survey of 27 burn unit nurses and 20 surgery resident. The survey contains a scenario of 3% total body surface area burn patient with eschar on his forearm that required graft surgery. First scenario: The patient rates his pain 8/10 the next day after his 10mg oxycodone 3 hours prior. Second scenario: The same patient has 6/10 pain 6 hours after the first scenario. Both these questions are followed with multiple choice questions regarding pain management options for the patient with combinations allowed. Survey also includes a questionnaire regarding NRS. The responses were rated from 5 being “strongly agree” to 1 being “strongly disagree” and 3 being “neutral.” In both scenarios, residents are more willing to pursue lower dose oxycodone (5mg) than nurses who are more willing to pursue a higher dose (15mg). Our results indicate that although similar in pain management approach, residents and nurses differ in pain treatment options. The discrepancy in oxycodone usage could be from residents being not as trusting and satisfied with NRS than nurses, all the while both professions feeling patients rate their pain higher than actual. If there is any NRS interpretation disparity, there will likely be pain management disparity. This study emphasizes the importance of communication among residents and nurses to provide a balanced pain treatment. It also highlights the need for an objective and standardized way of measuring and treating pain. Better patient pain management and quality outcome.