Date
of Last Review: 3/21/07
SME: Associate Director of Nursing
The assessment of pain and its management is multidisciplinary in nature and
is shared among all physicians, nursing staff, and other clinicians. Pain management
is monitored through Performance Improvement.
This procedure is based on the hospital's Pain Management Plan which supports our mission of patient care. The plan acknowledges that patients have a right to have their pain assessed and managed through techniques that respect their dignity, autonomy, positive self-regard, civil rights, and involvement in their own care.
Staff receive pain management education during New Employee Orientation and annually thereafter. Both pain assessment and management are included in nursing staff competencies.
The pain assessment process is as follows:
Step |
Action | ||||||||||||
1 |
The physician assesses for pain during the Initial Psychiatric Examination (IPE). | ||||||||||||
2 |
Additionally, nursing staff screen for pain in the Initial Nursing Assessment. | ||||||||||||
3 |
When a patient has a positive pain history, as identified in the nursing assessment, the following information is obtained from the patient:
| ||||||||||||
4 |
When pain is identified upon admission or during the hospital stay, nursing staff reassess ongoingly as follows:
| ||||||||||||
5 |
As appropriate, pain management may become part of the Master Treatment Plan. | ||||||||||||
6 |
Nursing staff apprise the attending physician of patients experiencing pain. Pain Management Guidelines/Modalities are implemented per physician's order. | ||||||||||||
7 |
Nursing staff assess/reassess pain and interventions to alleviate pain and document in the medical record. Note: Ineffective pain management is discussed with the treatment team and the treatment plan and/or physician orders are revised as appropriate. | ||||||||||||
8 |
During the admission process, nursing staff educate the patient on her/his rights to pain management and the right to self-report pain. Documentation: Pain education is documented on the Patient/Family Education Sheet. | ||||||||||||
9 |
The patient/family receive ongoing education (i.e. pamphlets, groups, referrals, etc.) as appropriate. Documentation: Pain education is documented on Patient/Family Education Sheet and/or in the progress notes. |
Related to regulatory standards
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