PAIN MANAGEMENT and the JCAHO Standards
M. Ron Eslinger
RN, CRNA, APN, MA, BCH, FNCH
Pain:The 5th Vital Sign
“An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
INTERNATIONAL ASSOCIATION FOR THE STUDY OF PAIN -The Challenge of
JCAHO January 2001
- EMPHASIS
- Collaborative and interdisciplinary approach
- Individualized pain – control plans
- Assessment and frequent reassessments with appropriate documentation
- Pharmacologic and nonpharmacologic approaches
- Establishment of a formalized approach to pain management
JCAHO – New Standards – 1
- RI.1.2 Section of JCAHO Standards calls for patients to be involved in all aspects of their care
- Provide statement of patient’s rights
- Provide info about pain and pain relief measures
- RI.1.2.8 of JCAHO Standards states that patients have a right to appropriate management and assessment
- Plan, support, and coordinate assessment and mgmt of pain
- Educate staff in proper assessment and mgmt of pain
JCAHO – New Standards – 2
- PE.1.4 of JCAHO Standards requires assessment of pain in all patients, including ID of patients in pain, reassessment and f/u
- Educate staff in:
- proper pain assessment
- Barriers to reporting pain
- Proper use of analgesics
JCAHO – New Standards – 3
- TX.5.4 of JCAHO Standards expects hospitals to monitor patients post-procedure
- Assess pain when making decisions about discharge in terms of:
- Changes in quality of pain
- Changes in intensity of pain
- Response to treatment
- Follow-up care
JCAHO – New Standards – 4
- PF.1.7 of JCAHO Standards calls for patients to be taught that pain management is a part of treatment
- Offer patients and families instructional material about pain management to meet their ongoing needs
- Provide educational materials that are easy to understand
JCAHO- New Standards
- CC.6.1 of JCAHO Standards provides for a continuum of care upon discharge
- Consider patient’s needs upon discharge
- Provide services to help meet those needs
- JCAHO – In a Nutshell – 1
- Rights and Ethics: recognize the right of individuals to appropriate assessment and management of pain
Hypnosis, Biofeedback and Psychotherapy are considered PSYCHOLOGIC TECHNIQUES for treating pain.