Improving the Quality of Care Through Pain Assessment and Management

Education about safe pain management will help prevent undertreatment of pain and the resulting harmful effects. Safety includes the use of appropriate tools for assessing pain in cognitively intact adults and cognitively impaired adults. Otherwise pain may be unrecognized or underestimated. Use of analgesics, particularly opioids, is the foundation of treatment for most types of pain. Safe use of analgesics is promoted by utilizing a multimodal approach, that is, using more than one type of analgesic to treat the individual’s pain. Opioid use is often avoided or inadequate for fear of causing life-threatening respiratory depression. Nurse monitoring of sedation levels when opioids are initiated is one way to assure safety. While nondrug techniques pose minimal safety issues, the current evidence does not support that these techniques produce consistent, predictable pain management outcomes.

[1]  Anne Chandler,et al.  Using heat therapy for pain management. , 2002, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[2]  S J Dolin,et al.  Tolerability of acute postoperative pain management: nausea, vomiting, sedation, pruritus, and urinary retention. Evidence from published data. , 2005, British journal of anaesthesia.

[3]  Mark F. Beck Milady's theory and practice of therapeutic massage , 1994 .

[4]  S. Resch,et al.  Postoperative cryotherapy after total knee arthroplasty: a prospective study of 86 patients. , 2006, The Journal of arthroplasty.

[5]  John Lynch,et al.  Validation of World Health Organization Guidelines for cancer pain relief: a 10-year prospective study , 1995, Pain.

[6]  C. Cleeland,et al.  Minority cancer patients and their providers , 2000, Cancer.

[7]  J Zuckerman,et al.  Impact of relational coordination on quality of care, postoperative pain and functioning, and length of stay: a nine-hospital study of surgical patients. , 2000, Medical care.

[8]  K. Cain,et al.  Nociceptive and neuropathic pain in patients with lung cancer: a comparison of pain quality descriptors. , 2001, Journal of pain and symptom management.

[9]  M. Halm,et al.  Effects of Music Therapy on Physiological and Psychological Outcomes for Patients Undergoing Cardiac Surgery , 2006, The Journal of cardiovascular nursing.

[10]  Richard M. Marks,et al.  Undertreatment of Medical Inpatients with Narcotic Analgesics , 1973 .

[11]  M. Good,et al.  Relief of postoperative pain with jaw relaxation, music and their combination , 1999, Pain.

[12]  Katherine R. Edwards,et al.  When is cancer pain mild, moderate or severe? Grading pain severity by its interference with function , 1995, Pain.

[13]  R. Soto,et al.  Capnography Accurately Detects Apnea During Monitored Anesthesia Care , 2004, Anesthesia and analgesia.

[14]  Daniel S. Laferriere,et al.  A 10-year review of quality improvement monitoring in pain management: recommendations for standardized outcome measures. , 2002, Pain management nursing : official journal of the American Society of Pain Management Nurses.

[15]  C. Cleeland,et al.  Pain and its treatment in outpatients with metastatic cancer. , 1994, The New England journal of medicine.

[16]  F. Harrell,et al.  Effects of adjunctive Swedish massage and vibration therapy on short-term postoperative outcomes: a randomized, controlled trial. , 2003, Journal of alternative and complementary medicine.

[17]  P. Griffiths,et al.  The impact of foot massage and guided relaxation following cardiac surgery: a randomized controlled trial. , 2002, Journal of advanced nursing.

[18]  B. Furrow Pain Management and Provider Liability: No More Excuses , 2001, Journal of Law, Medicine & Ethics.

[19]  D. Turk,et al.  American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force. , 2005, Archives of internal medicine.

[20]  Kimberly D. McCoy,et al.  Effects of depression and pain severity on satisfaction in medical outpatients: analysis of the Medical Outcomes Study. , 2007, Journal of rehabilitation research and development.

[21]  Pain control. Pain assessment in cognitively impaired older adults: new strategies and careful observation help pinpoint unspoken pain , 2002 .

[22]  Thomas Hadjistavropoulos,et al.  Development and preliminary validation of the pain assessment checklist for seniors with limited ability to communicate (PACSLAC). , 2004, Pain management nursing : official journal of the American Society of Pain Management Nurses.

[23]  D. Goldstein,et al.  Meeting proceedings: Recommendations for improved acute pain services: Canadian collaborative acute pain initiative Recommendations for improved acute pain services: collaborative acute pain initiative. , 2016 .

[24]  M. Good,et al.  Systematic relaxation to relieve postoperative pain. , 2004, Journal of advanced nursing.

[25]  S. Mercadante Pain treatment and outcomes for patients with advanced cancer who receive follow‐up care at home , 1999, Cancer.

[26]  Y. D'arcy Pain management standards, the law, and you. , 2005, Nursing.

[27]  J. Bland,et al.  Effectiveness of acute postoperative pain management: I. Evidence from published data. , 2002, British journal of anaesthesia.

[28]  R. Melzack The McGill Pain Questionnaire: Major properties and scoring methods , 1975, PAIN.

[29]  K. Seers,et al.  Relaxation techniques for acute pain management: a systematic review. , 1998, Journal of advanced nursing.

[30]  S J Dolin,et al.  Respiratory and haemodynamic effects of acute postoperative pain management: evidence from published data. , 2004, British journal of anaesthesia.

[31]  M. Mccaffery,et al.  No self-report means no pain-intensity rating. , 2005, The American journal of nursing.

[32]  C. Cleeland,et al.  Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases , 1983, Pain.

[33]  K. Kwekkeboom,et al.  Systematic review of relaxation interventions for pain. , 2006, Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing.

[34]  Graves Ej,et al.  National Hospital Discharge Survey , 2004 .

[35]  S. Follin,et al.  Acute Pain Management: Operative or Medical Procedures and Trauma , 1997, The Annals of pharmacotherapy.