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Quality & Safety

Managing Patient Pain and Alternative Pain Management Strategies

SONIFI Health By SONIFI Health
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January 30, 2018

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“Rate your pain on a scale from 1-10 with 1 being no pain and 10 being the worst pain imaginable.”

For years doctors and nurses have used this number scale to try to determine the severity of a patient’s pain. This information is usually used to determine the appropriate dosage of pain relievers, such as opioids, to administer.

Opioid Use

Opioids can be effective for temporarily relieving pain, which often makes the drugs a useful treatment for short-term acute pain or for terminal cancer-related pain, as the long-term effects of sustained opioid use aren’t a significant concern. The situation is not as straightforward when it comes to pain management for those who suffer from chronic pain.

According to Roger Fillingim, Ph.D., professor and director of the Pain Research Intervention Center of Excellence at the University of Florida, prolonged use of opioids for pain management results in patients needing higher and higher doses to achieve the same relief. This unfortunate truth is perfect breeding grounds for the opioid epidemic.

According to Fillingim, the healthcare and research industries need to focus on exploring and implementing alternative methods for pain control.

Pain Measurement: More than a Number

Pain measurement can be subjective. Self-reported ratings will not be consistent from patient to patient. What one person rates as a 4 could be another person’s 8 on a 1-10 scale. Relying solely on the patient-given rating of the pain severity can be limiting when it comes to pain management.

Pain measurements will always be subjective. It is important that patients understand how to use the scale to communicate their pain level and management goals. A goal of being able to sleep is different than needing to sit comfortably at work. The pain severity numbers should be part of a pain management discussion.

Pain level is, of course, an important factor in determining pain management strategies. Healthcare professionals could also ask questions regarding the pain’s impact on the patient’s life. Are they able to complete their daily activities? Is the pain an annoyance or an interference?

The CMS and the HCAHPS Pain Score

The Centers for Medicare and Medicaid (CMS) recently announced their intention to remove and revise the current pain management questions from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. CMS will be researching alternative questions as a reaction to the discovery of an unintended consequence: increased opioid use.

The healthcare industry, as a whole, could benefit from shifting its approach to pain management to reflect a more multifaceted approach.

Alternative Approaches

Pain management is so much more than an accurate dosage. Pain relief is just one side of the coin, patients must also have the tools and knowledge they need to effectively cope with pain as well.

An individualized education plan to teach patients about monitoring and communicating on their pain has shown promise to improve pain management. Allowing for earlier interventions and strategies reduces the likelihood the patient will need pharmaceutical intervention to control their pain.

Instead of relying solely on opioids and other pain medication, a comprehensive pain management strategy can include things like stretching and physical therapy as well as positive distraction options such as reading, music, etc.

Nurses have found positive distraction to be an effective pain management technique. Positive distraction is often referred to as patient entertainment, but the benefit of patient access to movies, games and music goes beyond keeping the patient occupied and entertained. When patients sit in hospital waiting or recovery rooms with nothing to do or think about except for their pain, they often experience increased anxiety and report high levels of pain. Research has found that positive distractions can help patients relax and even alter their thoughts and emotions. These distractions can be a beneficial part of pain management strategy.

Contact SONIFI Health to learn more about how our interactive patient systems can help improve your patients’ hospital experience. Our system offers several options to help ease your patients’ pain and anxiety. Options include music, movies, video games, religious content, relaxation resources, a puppy channel, and more.

References
  1. Skerrett, P. (2015, November 30). Treating chronic pain: when ‘how much does it hurt?’ isn’t enough. Retrieved from https://www.statnews.com/2015/11/30/chronic-pain-intensity-scale/.
  2. Gordon, E. (2016, September 8). Reassessing the assessment of pain: how the numeric scale became so popular in health care. Retrieved from https://whyy.org/segments/reassessing-the-assessment-of-pain-how-the-numeric-scale-became-so-popular-in-health-care/
  3. McCaffery, M. RN, MS, FAAN (2002) Teaching your patient to use a pain rating scale. Retrieved from http://journals.lww.com/nursing/Citation/2002/08000/Teaching_your_patient_to_use_a_pain_rating_scale.13.aspx
  4. CMS removes pain management questions from HCAHPS survey. (2016, November 7). Retrieved from American Society of Anesthesiologists: http://www.asahq.org/advocacy/fda-and-washington-alerts/washington-alerts/2016/11/cms-removes-pain-management-questions-from-hcahps-survey?page=6

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