Research Proposal: Ethical Issues in Pain Management in Acute Care

This report presents a research proposal focused on the emerging ethical issues in pain management within the acute care setting, specifically addressing the responsibilities of nurses. The proposal includes an introduction highlighting the importance of effective pain relief and the current challenges in achieving it. A review of the literature provides background information on pain management methodologies, the influence of bias, and the importance of ethical principles. The rationale for the research emphasizes the need for effective pain management in patient care. The methodology outlines a structured approach to pain management, including reviewing literature, adhering to policies, and consulting with relevant parties such as physicians and ethics committees. The significance of the research underscores the potential adverse outcomes of poorly managed pain and the importance of maintaining quality of life. The conclusion reinforces the ethical obligation of pain management and the need for comprehensive training and guidelines. The report follows a standard research proposal format, including sections on introduction, literature review, rationale, methodology, significance, and conclusion, along with references to support the arguments and findings. The report aims to provide a framework for future research on ethical considerations in pain management and their implications for nursing practice.

Emerging Ethical Issues in Pain Management in the Acute
Care Setting
1. Introduction
Proper pain relief for hospitalized patients remains a distant reality. The results of
HCAHPS show that around 70% of patients hospitalized across the country reported that
their pain was reduced. (Summary of HCAHPS Survey Results, 2011). Although the
research on pain management has resulted in a better concept on pain related issues,
with the new advancement in pain treatment methodology, patients have given better
feedback on reduction of pain and have expressed more confidence in the the
management of their pain in the hospital (Department of Health and Human Services,
2011).
2. Background/review of the literature
Pain management is a fast-growing science that utilizes technology pharmacology and
complementary therapies to provide comprehensive safe treatment Appropriate pain
management creates relief, comfort and well-being. Effective pain management allows major
operations to be performed, improves quality of life and reduces the length of stay in the
hospital.
The decisions on treatment methodology are typically influenced by bias and emotion
due to the inherent perception of pain. Compliance with ethical principles provides a really
sensible, unemotional approach of making the correct decision, All decisions on pain
management should be made with lot of consideration, application of mind and transparency
for everybody involved. (Pullman, 2013).
Another important aspect is that pain management should be given due importance in the
course curriculum of nursing courses.
3. Rationale
A healthcare unit supports effective pain management as one of the important activities
of effective patient care.

4. Method and design
Pain-killer is applied to a patient for temporary relief of pain. This medicine does not
cure the cause of pain. In addition, all painkillers have some side effects. The medicine may
affect liver function when it is taken with alcohol or in large quantity. A strong dose of
analgesics often causes dizziness, drowsiness, and respiratory problems. Though the side
effects may subside after a certain time lever problem or constipation tends to persist. So,
before applying any kind of pain-killer, the following steps should be followed. (Samuels,
2010)
The literature coming with the painkiller should be reviewed.
 The existing policy on pain management has to be followed by the healthcare unit. If
the unit is not having any pain management policy, the nurse has to consult the medical
officer on analgesic use.
 If the patient has a history of any drug abuse, the patient should be referred to a pain
management service, specialized nursing care program, or the abuse of substance
treatment program as a special case.
 The physician is to be consulted privately regarding concerns about the ethics of pain-
killer administration. The main task is to provide a plan of care that provides the
patient with relief of pain.
 The patient and his/her relatives are to be informed about the effective pain
management program. The nurse can offer to accompany the physician to inform the
patient that he/she was taking a pain-killer for pain relief but because of the reasons, a
new pain management plan will be applied.
 The hospital’s ethics committee is to be informed about the ethical issues that are
raised by the use of a pain-killer for pain.
 The hospital’s risk manager is to be kept informed about any legal liability associated
with a failure to manage pain effectively.
5. Significance
The significance of pain management is that in case of improperly managed pain, the
incident may lead to adverse psychological as well as physical outcomes for the patients

and their families. It is also a fact that patients who had an unpleasant experience on pain
management from a healthcare unit may not prefer the same unit for treatment of other
health problem.
Managing pain is important for maintaining normal quality life. Pain prevents
individuals from doing things their normal works smoothly. Pain affects mood and
ability to concentrate People with severe pain cannot sleep and do not feel like eating
food. It may affect health and create symptoms of other disease. Pain also can, increase
heart beat rate and blood pressure..
6. Conclusion
We can come to the following conclusion on the basis of the above deliberations:
 The treatment of pain is an ethical obligation,
 Healthcare institutes should train health care professionals extensively on different
aspects of pain management.
 Pain management should be given due care when a patient is admitted to a medical
unit Proper guidelines should be followed by nurses before administering any pain-
killer to a patient.
 A well-established framework for pain management enhances both quality and
assurance, the ultimate beneficiaries are the patient as well as the healthcare unit.
References
Department of Health and Human Services. (2011). Hospital compare. Retrieved August 10,
2011 from www.hospitalcompare.hhs.gov/
Pullman, D. (2013). Ethics of Pain, Human Dignity, and the Ethical Management of Pain and
Suffering. Encyclopedia of Pain,1199-1201. doi:10.1007/978-3-642-28753-4_1381
Samuels, J. (2010). The Application of High-Reliability Theory to Promote Pain
Management. JONA: The Journal Of Nursing Administration, 40(11), 471-476. doi:
10.1097/nna.0b013e3181f88a41
Summary of HCAHPS survey results. cahpsonline.org/HCAHPS_Executive_Insight. July 2009-
June 2010. (2011). Centers for Medicare & Medicaid Services, Baltimore, MD. Retrieved
July 22, 2011 from www.hcahpsonline.org/files/Summary%20of%20HCAHPS
%20Survey%20Results%20Table%20Report_HEI_April_2011.pdf