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Practices evaluated for pain assessment
Cancer hospice patients examined
A study published in the Journal of Pain and Symptom Management finds gaps in the use of evidence-based pain assessment and treatment practices for older adults with cancer in community-based hospice settings.1
Using a tool developed by the researchers to measure evidence-based pain management practices, patients received an average of 32% of those key evidence-based practices (EBPs) that were applicable to their situations. When examining individual practices, most of the patients had their pains assessed at admission using a valid pain scale (69.7%) and had primary components of a comprehensive assessment completed at admission (52.7%); most patients with admission reports of pain had an order for pain medication (83.5%).
Data did reveal a number of practice gaps, including additional components of a comprehensive assessment completed within 48 hours of admission (0%); review of the pain treatment plan at each reassessment (35.7%); reassessment of moderate or greater pain (5.3%); consecutive pain reports of 5 or greater followed by increases in pain medication (15.8%); monitoring of analgesic-induced side effects (19.3%); initiation of a bowel regimen for patients with an opioid order (32.3%); and documentation of both nonpharmacological therapies (22.5%) and written pain management plans (0.6%).
The authors conclude that although hospices are using some best practices for pain assessment and treatment, there are many areas in which hospices can improve.
1. Herr K, Titler M, Fine P, et al. Assessing and treating pain in hospices: current state of evidence-based practices. J Pain Symptom Manage 2010; 39:803-819.