patient controlled analgesia using the baxter pca ii pump

1. 1 Patient Controlled Analgesia Using the Baxter PCA II Pump Maniilaq Health Center Acute Care December 2006 Dara M. Whalen, RN, MS Nurse Educator

2. 2 Objectives Discuss the indications and use of Patient Controlled Analgesia using the Baxter PCA II Pump Discuss the Maniilaq Health Center policy and procedure related to use of a PCA pump Discuss the risks and benefits of the PCA pump as a delivery system

3. 3 Objectives continued Relate the precautions to be used when a patient is receiving analgesic medication through the PCA pump Discuss the proper documentation related to PCA use Demonstrate (using the demonstration syringe and tubing) set up and use of the Baxter PCA II pump

4. 4 Objectives continued Discuss the patient teaching information that must be given to the patient or caregiver.

5. 5 Indications and use of a PCA pump Pain � the 5th vital sign according to JCAHO Uncontrolled pain (stress) can affect immune system at the cellular level, affect wound healing Pain is subjective, the patient directs the expression of their pain and the evaluation of the success of treatment Pain can be acute or chronic PCA�s used for acute pain as well as chronic pain

6. 6 Indications continued Loss of control can increase anxiety and pain in those with little overall control PCA can give control back to the patient and family Provides more effective pain relief than intermittent or scheduled pain medication Typically see lower total numbers of mg�s used in 24 hour period

7. 7 Indications continued Most often used comfortably (provider) with end of life situations Once the pump is set it is less labor intensive for the nurse even though the monitoring is more frequent More?

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9. 9 Policy and Procedure P & P in process of being reviewed, review with staff Orders being reviewed, taken from ANMC Very safe mechanism of delivery, safeguards in place both in the machine and the policy and procedure

10. 10 P & P continued Verification of order by two staff (2 RN�s or RN and Pharmacist) I suggest verification by outgoing and oncoming RN at change of shift (look at pump and record dose verification) Medication administration record to be used for documentation, has complete instructions for delivery of medications and evaluation

11. 11 Risks and Benefits Over sedation � rarely a problem, dose is low and monitoring is frequent Safety � system is locked and accountability is high Use the P & P to monitor and treat possible complications Patient has control over medication administration and dosing

12. 12 Risks and Benefits continued Pain can be controlled better with smaller frequent dosing rather than bolusing Others:

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14. 14 Patient Teaching How to use the pump How often it can deliver the medication Who should press the button What to look for: over sedation, itching, respiratory depression Need to report inadequate pain control Assure them that you will be monitoring them frequently

15. 15 Demonstration Hands on demonstration Competency evaluation New staff education Keeping skills up, document when you do this so you can get credit for education Yearly competency

16. 16 Conclusion PCA Pumps are effective tools in controlling pain Technology is always changing Hands on practice is needed to be comfortable with the process Safety is key, follow the procedure, assess your patient