Pain management teaching guide can help meet JCAHO standards

Advantage Home Health in Savannah, GA, has devised a three-page patient guide to pain management. The guide is handed out to each patient at admission, and lets patients know what their rights are with regard to their pain.

The tool also discusses ways to relieve pain, side effects of pain medication, and other barriers to managing pain successfully. The teaching guide meets the patient education requirements of the new pain management section of the accreditation manual of the Joint Commission on Accreditation on Healthcare Organizations in Oakbrook Terrace, IL. Here is a look at the Advantage Home Health patient education guide on pain management:

Pain Management - A Patient Guide

Dear Patient or Caregiver:

The nurse will teach you about pain control. Then you can use this Teaching Guide as a reminder.

Your nurse is _________________________.

The phone number is ___________________.

What is pain?

Pain is an unpleasant sensation caused by different stimulations of the sensory nerve endings.

What are your patient rights in relation to pain?

• That your reports of pain will be believed.

• To receive information about pain and how your pain can be relieved.

• Agency staff who are committed to pain prevention and management.

• Agency staff who will respond quickly to your reports of pain.

• Best pain control possible.

• Pain medication information for drugs ordered by your doctor (side effects, precautions).

What are your responsibilities in relation to your pain control?

• Ask the nurse what to expect regarding your pain and pain management.

• Discuss pain relief options with your nurse.

• Work with the nurse to develop a pain management plan.

• Ask for pain relief when pain first begins.

• Help the nurse assess your pain.

• Tell the nurse if your pain is not relieved.

• Tell the nurse about any worries you have about taking pain medications.

What will the nurse need to know about your pain?

• Frequency (how often it occurs);

• Location (where it occurs);

• Duration (how long it lasts);

• Intensity (describe the pain on a scale of 0-10; 0 = no pain; 10 = worst possible pain);

• Character (use your own words to describe the pain);

• Things you do that help you get rid of the pain;

• Things you do that make the pain worse;

• Effects of pain on your daily life (appetite, sleep, emotions, activities, etc.).

What are some barriers to managing pain?

• Not understanding the pain.

• Thinking pain cannot be relieved.

• Thinking pain is a normal part of the disease and should be present.

• Thinking that you are not a good patient if you have pain.

• Thinking that medicine causes addiction.

• Not being able to afford to pay for pain medicine.

• Side effects of pain medicine are too hard to manage.

• Hard time getting pain medicine refills.

• Hard time telling others about your pain.

Please tell the nurse if any of those barriers (or others) are true for you so that we can help you overcome them.

What are some other ways to relieve pain, in addition to my medicine?

• Relaxation (deep-breathing exercises, abdominal breathing, with or without calming music in the background);

• Distraction (watching nonstressful or comedy TV, listening to peaceful music or recordings, such as waterfalls, ocean sounds, or other environmental sounds that are relaxing to you);

• TENS (transcutaneous electrical nerve stimulation). This can be ordered by your doctor. It can be obtained from your medical equipment supplier.

• Massage (with medicated cream or ointment as ordered by your doctor, or with your favorite lotion);

• Heat (check with your doctor or nurse to be sure that wet or dry heat will not make the pain worse or cause problems with other ailments that you may have);

• Cold (check with your doctor or nurse to be sure that cold will not cause problems with other ailments that you may have).

What are some of the side effects of pain medication and how can they be controlled?

1. Nausea/Vomiting

• other medicines can be ordered to control or prevent this;

• check to see if you should avoid taking the pain medicine on an empty stomach;

• increase your fiber intake;

• increase your fluid intake;

• abdominal massage — rub from right to left across the upper abdomen and down the left side for 2-4 minutes;

• using a mild laxative, suppository, or enema as ordered by your doctor;

• the nurse can teach you or a caregiver how to do digital stimulation if this will not aggravate any other ailment you may have.

2. Sedation

• drinking coffee or other caffeinated beverages — if this will not aggravate any other ailment you may have;

• having the doctor adjust the dose for daytime use, or having the doctor order two different medicines — one for mild pain and one for severe pain.

3. Diarrhea

• other medicines can be ordered to control or prevent this;

• decrease your fiber intake;

• must still drink plenty of fluids to prevent dehydration.

What is your goal for your pain management? Tell the nurse or write it out on the lines provided:

Please use the pain management log to keep track of your pain. Share it with the nurse when she or he visits.