Pain Assessment and Management at an Academic Hospital: A Needs Assessment

Background: Every patient has the right to have their pain treated and to do so without discrimination. Pain must be measured accurately with a multidimensional approach to then identify safe, effective ways to manage the pain. Inadequate assessment and treatment of pain can have negative impacts on patient outcomes. Local Problem: Hospital accreditation visit findings at an academic hospital revealed that documented patient pain scores and corresponding as-needed pain medication given per provider order did not consistently match. Methods: A needs assessment was conducted to assess the facilitators and barriers to the current pain policy. Survey results, recommendations from professional pain management organizations, and expert opinion were used to assess the current pain policy. Eight recommendations were provided to the Pain Management Workgroup. The usability, feasibility, and satisfaction of those recommendations assessed. Results: Forty-seven percent of nurses said the pain policy was overall helpful. However, most of these nurses had less than two years of nursing experience (69%) whereas most of the nurses who said the pain policy was overall not helpful (35%) had greater than three years of nursing experience (83%). One barrier identified was the mismatch in the severity of a patient's pain score and the as-needed pain medication that was correlated to that severity level in the provider order. Another barrier was that the pain policy did not provide a multidimensional approach to pain. The Pain Management Workgroup overall found the recommendations usable, feasible, and satisfactory, and plan to incorporate six out of the eight recommendations into the new pain policy. Conclusion: These results will help the Pain Management Workgroup produce an improved pain policy for this academic hospital.