[Bev Gibson]

#85622

All of our admissions have a routine genogram done. This is a very handy tool for any new staff member dealing with the patient to be able to glance at and familiarise themselves with the patient’s family and the family dynamics.
For pain assessment, we use the FLACC scale for our smaller, non communicative children, not that we’ve had many, as we’re predominantly an adult Hospice, or the Wong- Baker numerical face chart for our older children and adults. I’ve found the Wong-Baker to be a very effective tool once the children and adults grasps the concept. I have even taken photos that I’ve saved to a mom’s camera roll so she can monitor her child’s pain when I’m not there or when they’re in hospital having treatment. Our greatest frustration is that there doesn’t seem to be a follow through when the children are hospitalised- the nurses don’t seem to use the Wong-Baker charts to asses their pain levels regularly? Has anyone else also found that to be true?

[Charne Cox (Loe)]

#85646

For the assessment of pain I also often use the FLACC scale. We have a lot of severely disabled children so this tends to be the tool I use the most. For the older and higher functioning children I use the Wong Baker Faces Pain Scale. The other day I used the PatchSA colour body tool. This worked really well and the results were quite interesting. I will definitely be using it more in future and showing the nurses in the unit this tool as well.
We also find that the nurses are not really using the different pain scales enough. I am not sure if it is possibly more that they do not know fully how to administer them. At each child’s bed we have a file that we call the Journey pack. In this file we put information sheets, bed exercise programmes etc. My thought is to possibly do the PatchSA colour body tool and then put this in that file for the nurses and doctors to see. I will redo the tool weekly and then the team can see the changes weekly as well. First prize would be to put this tool above the patients bed but with POPIA the file would probably be safer. Any thoughts on this?

[Bev Gibson]

#86877

Yes, even though I understand why it’s necessary, I sometimes I think this POPI act is one of the worst things for our patients!
Does your Journey Pack include the nursing process and med chat etc? Would a separate sleeve containing the Patch colour body tool kept in the same place as the nursing process not be helpful and more accessible for the nurses to see it when they write their reports? If it was easily accessible and dated with the relevant date and time, then it may be useful but, ideally pain should be monitored more often than once a week, it should actually be monitored more often than once a day even. In fact, as we’ve seen now that we’ve done the pain management module, if the child is on analgesics, or having procedures that cause pain, we should be reassessing at least 4 hourly to assess the effectiveness of the analgesic treatment.

We have just had to adapt a pain scale because one of our little patients (4years old) has recently had his second eye enucleated due to retinoblastoma and can no longer see any of the tools he was previously accustomed to. We have ‘created’ our own pain rating tool using his hand- if he has no pain (0/5), he makes a fist (like a zero!), a little pain (1-2/5), he shows 1 finger, and so on, and unbearable pain (5/5), he shows 5 fingers raised. He has grasped this quite well and his mom says he has even told some of the nurses in the hospital how it works!

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