Nurses' attitudes toward pain, pain assessment, and pain management practices in long-term care facilities

Background. Although feasible protocols for pain assessment and management in long-term care (LTC) have been developed, these have not been implemented on a large-scale basis.Objective. To implement a program of regular pain assessment in two LTC facilities, using implementation science principles, and to evaluate the process and success of doing so.Methods. The implementation protocol included a pain assessment workshop and the establishment of a nurse Pain Champion. Quality indicators were tracked before and after implementation. Focus groups and interviews with staff were also conducted.Results. The implementation effort was successful in increasing and regularizing pain assessments. This was sustained during the follow-up period. Staff members reported enthusiasm about the protocol at baseline and positive results following its implementation. Despite the success in increasing assessments, we did not identify changes in the percentages of patients reported as having moderate-to-severe pain.Discussion. It is our hope that our feasibility demonstration will encourage more facilities to improve their pain assessment/management practices.Conclusions. It is feasible to implement regular and systematic pain assessment in LTC. Future research should focus on ensuring effective clinical practices in response to assessment results, and determination of longer-term sustainability.

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Elderly pain assessment and pain management knowledge of long-term care nurses

Pain Management Nursing ◽

10.1053/jpmn.2000.9294 ◽

2000 ◽

Vol 1 (3) ◽

pp. 88-95 ◽

Cited By ~ 22

Author(s):

Diane L. Katsma ◽

Christine Hamlow Souza

Keyword(s):

Pain Management ◽

Pain Assessment ◽

Long Term Care ◽

Term Care ◽

Management Knowledge

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Building an Institutional Commitment to Pain Management in Long-Term Care Facilities

Journal of Pain and Symptom Management ◽

10.1016/s0885-3924(00)00168-8 ◽

2000 ◽

Vol 20 (1) ◽

pp. 35-43 ◽

Cited By ~ 34

Author(s):

David E Weissman ◽

Julie Griffie ◽

Sandra Muchka ◽

Sandra Matson

Keyword(s):

Pain Management ◽

Long Term Care ◽

Institutional Commitment ◽

Term Care ◽

Care Facilities

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Acceptance Rates for Pharmacist-Initiated Interventions in Long-Term Care Facilities

INNOVATIONS in pharmacy ◽

10.24926/iip.v4i4.317 ◽

2013 ◽

Vol 4 (4) ◽

Cited By ~ 2

Author(s):

Gina L. Carson ◽

Kimberly Crosby ◽

Garrett R. Huxall ◽

Nancy C. Brahm

Keyword(s):

Pain Management ◽

Drug Utilization ◽

Chart Review ◽

Long Term Care ◽

Inclusion Criteria ◽

Term Care ◽

Medication Therapy ◽

Care Facilities ◽

Acceptance Rates

Objectives: Describe individualized medication interventions, categorize intervention types, and report acceptance rates by prescribers following a pilot medication intervention program in which a pharmacist rounded with the patient care team in long-term care facilities in addition to their traditional medication regimen review (MRR) process. Design: Prospective Chart review Setting: Two primary long-term care (LTC) facilities Participants: Fifty randomly selected patient charts. Inclusion criteria were adult patients (18 years old or older) residing in one of the LTC facilities receiving consultant pharmacist services. Patient charts not meeting inclusion criteria were excluded from the review. Interventions: Recommendations made according to the needs of each patient and categorically reported. Main Outcome Measures: Intervention acceptance rates by prescribers and aggregate reporting for type of medication interventions. Results: For 50 patient charts (68% female, 32% male) 66 interventions were reported. The average patient age was 81.5 years. Approximately 45% of the interventions pertained to drug utilization concerns, and 21% involved pain management. Additional categories included treatment of eye and skin conditions and pharmacotherapy for mental health. A 'nonpharmacotherapy' designation was given to individual interventions not fitting into a larger category. New medications and regimen changes were the most common medication therapy outcomes (42% and 32%, respectively). Overall 92% of all pharmacist interventions were either fully or partially accepted by the prescriber where partial acceptance was defined as implementation of the recommendation with an adjustment. Interventions related to drug utilization or pain management each approached a 93% acceptance rate. Conclusions: The consultant pharmacist provided personalized recommendations following extensive chart review and patient assessment. Our chart review suggests that high prescriber acceptance rates along with medication therapy optimization may produce similar benefits in other LTC facilities. Type: Original Research

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