Do You Ask Your Patients about Dyspnea?
As a CE article this month, we feature a report of a pilot study on routine assessment of dyspnea on admission to a patient unit. It’s routine to take vital signs on all patients on admission, but really, how many nurses actually stand there and count respirations for all patients? And even if you are the exceptional nurse who does, that doesn’t necessarily tell you if the patient actually feels any shortness of breath. And then, of course, there’s the issue of whether it’s a good idea to add to the burden of documentation that many nurses are already concerned about.
This article reports on one group’s experience piloting a short dyspnea assessment tool for all admissions on several units. Here’s the abstract:
The assessment of dyspnea, like that of pain, depends on patient self-report. Expert consensus panels have called for dyspnea to be measured quantitatively and documented on a routine basis, as is the practice with pain. But little information is available on how to measure and record dyspnea ratings systematically. Consequently, the prevalence of dyspnea in hospital settings may be greater than is generally recognized, and dyspnea may be insufficiently managed. This article describes a pilot study that sought to test the feasibility of measuring dyspnea as part of the initial patient assessment performed by nurses within several inpatient units of a large urban hospital.
While most nurses in the pilot felt that assessing for dyspnea was important, a number felt that quantifying it and documenting it was less so. The article provides a revealing snapshot of some ways implementing an assessment can work and not work so well, according to unit type, patient condition, and the format of the required documentation.