Pain management nursing : official journal of the American Society of Pain Management Nurses
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Although much has been done to promote pain assessment and management, pain remains a major, yet largely preventable, public health problem in the United States. A strategy that has been proposed to assure optimal pain management is the development of formal means within institutions to evaluate pain management practices and foster improved outcomes. ⋯ A Pain Management Task Force was charged with the development of a comprehensive pain management program. Its efforts to date and plans for the future position this institution as ready for the Joint Commission for the Accreditation of Healthcare Organizations' pain assessment and management standards that were introduced in 2000.
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The newly approved Joint Commission on Accreditation of Healthcare Organizations (JCAHO) pain management standards present an important opportunity for widespread and sustainable improvement in pain assessment and management. Unrelieved pain is a major, yet avoidable, public health problem. Despite 20 years of work by educators, clinicians, and professional organizations and the publication of clinical practice guidelines, there have been, at best, modest improvements in pain management practices. ⋯ The revisions are published in the 2000-2001 standards manuals and will be effective January 1, 2001, for all patient care organizations accredited by JCAHO--ambulatory care, behavioral health, health care networks, home care, hospitals, long-term care, and long-term care pharmacies. An evaluation of the impact of the revisions is currently being completed, and education of the JCAHO surveyors and health care professionals is underway. Nurses, especially those with expertise in pain management, are valuable resources as health care organizations change their pain assessment and management processes to meet the new standards.
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Review Comparative Study
The checklist of nonverbal pain indicators (CNPI).
This article critiques the literature on existing pain assessment instruments for cognitively impaired elders and reports findings of pilot testing of the Checklist of Nonverbal Pain Indicators. This instrument was designed to measure pain behaviors in cognitively impaired elders. Instrument testing was conducted on a population of elderly patients with hip fractures. ⋯ Observed pain behaviors were positively correlated with self-report of pain. No differences between observed pain behaviors in cognitively intact versus cognitively impaired older adults with hip fractures were noted. Limitations of the instrument and recommendations for tool use are discussed.