Author:
Mary Ann Gureno, RN, MS
A collaborative effort to improve pain control in the young pediatric patient resulted in new policies and a change in pain management practice. A retrospective chart review of 15 pediatric surgical patients identified the use of patient controlled analgesia (PCA) as a successful method of pain control for children 3 years of age and older.
The Faces Rating Scale was adapted to a 5 point scale by combining faces O and 1 as no hurt at all. It was used to assess the child's pain while the child was on the PCA pump (average time on the pump was 82.7 hours). Out of 639 pain assessments, 72% were 1, 18% were 2, 7% were 3, 3% were 4, and less than 1% were 5.
Overall, the staff, patient, and families felt very comfortable using the Faces Rating Scale. The few difficulties we encountered were with the three year old children. The "young" three year olds did not seem to grasp the concept of matching their feelings with the face. In these situations the nurse matched the patients affect and behaviors with the scale to determine the score.
The majority of our surgical patients come directly to our unit from OR. It has been difficult to explain the use of the scale to the children when they return from surgery. Repeated explanations are needed during the first hours in post-op. We are incorporating an explanation of the Faces Scale in our pre-op party, however, not all children attend this program prior to surgery.
June 27, 1991
We continue to use your scale frequently. It is attached to each PCA pump, but I also see staff using it in other situations. To date, we have used the PCA pump with 92 patients (average age; 8 years old).
March 15, 2002
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