2.50
Hdl Handle:
http://hdl.handle.net/10755/165860
Category:
Abstract
Type:
Presentation
Title:
Pain management with oncology patients: Use of JCAHO's new pain standards
Author(s):
Cohen, Marlene
Author Details:
Marlene Cohen, PhD, Distinguished Professor, University of Texas Health Science Center-Houston School of Nursing, Houston, Texas, USA, email: Marlene.Z.Cohen@uth.tmc.edu
Abstract:
Unrelieved pain persists as a major problem for both cancer patients and other patients in pain. Addressing this is especially important since appropriate pain management improves many outcomes, including recovery, length of hospital stays, quality of life and productivity. In response to the need for adequate pain management, the Joint Commission of Accreditation on Health Care Organization (JCAHO) launched in 1999 new standards for organizations to better manage pain, to support patient's rights to pain relief, and to increase the priority for effective pain therapy. The guidelines ensure pain management is seen as a patient rights issue and an education and training issue, and they also promote systematic assessment, emphasizing the use of standardized pain instruments and safe management. In order to determine how well cancer pain is managed in a large medical center, a chart review was done to describe the documentation of the criteria in the new JCAHO Pain Management Standards. Policies and procedures were obtained from the hospitals that participated in this chart review. A Data Collection Tool created from the standards guided this review. A pilot study of 5 charts in each institution was conducted. The revised tool included 5 sections with 15 parameters (questions): Patient Assessment; Patient Education; Operative and other Procedures and Discharge Planning/Continuity of Care. Data were collected at 5 hospitals in a large metropolitan city in the southwest. The hospitals included one small community hospital, three large hospitals seeing a variety of patients, and one large hospital providing care to primarily oncology patients. The goal was to review 15 inpatient and 15 outpatient charts of oncology patients (a total of 150 charts, 75 inpatient and 75 outpatient charts). The actual sample included a total of 119 charts, 82 inpatient charts and 37 outpatient charts. One of the data collectors was unable to find charts documenting pain in any cancer outpatients, and in two other hospitals fewer than 15 charts documenting pain in cancer patients were found. Pain intensity was noted in 57% of the charts, while treatment was noted in 86%. Reassessment after treatment was found in 50% of the charts. Little discharge planning noted pain management concerns (23% of charts), and almost no documentation (12%) of teaching or pain monitoring (30%) after operative or other procedures was found. In addition to the finding that no pain assessment was documented on many outpatients, when pain was assessed it was not done completely. These findings have been shared at each institution and various changes are being made to improve pain management and documentation. Work to properly manage cancer pain needs to continue, and the JCAHO standards provide another mechanism to evaluate practice and its documentation in order to improve care provided.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Host:
Southern Nursing Research Society
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePain management with oncology patients: Use of JCAHO's new pain standardsen_GB
dc.contributor.authorCohen, Marleneen_US
dc.author.detailsMarlene Cohen, PhD, Distinguished Professor, University of Texas Health Science Center-Houston School of Nursing, Houston, Texas, USA, email: Marlene.Z.Cohen@uth.tmc.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/165860-
dc.description.abstractUnrelieved pain persists as a major problem for both cancer patients and other patients in pain. Addressing this is especially important since appropriate pain management improves many outcomes, including recovery, length of hospital stays, quality of life and productivity. In response to the need for adequate pain management, the Joint Commission of Accreditation on Health Care Organization (JCAHO) launched in 1999 new standards for organizations to better manage pain, to support patient's rights to pain relief, and to increase the priority for effective pain therapy. The guidelines ensure pain management is seen as a patient rights issue and an education and training issue, and they also promote systematic assessment, emphasizing the use of standardized pain instruments and safe management. In order to determine how well cancer pain is managed in a large medical center, a chart review was done to describe the documentation of the criteria in the new JCAHO Pain Management Standards. Policies and procedures were obtained from the hospitals that participated in this chart review. A Data Collection Tool created from the standards guided this review. A pilot study of 5 charts in each institution was conducted. The revised tool included 5 sections with 15 parameters (questions): Patient Assessment; Patient Education; Operative and other Procedures and Discharge Planning/Continuity of Care. Data were collected at 5 hospitals in a large metropolitan city in the southwest. The hospitals included one small community hospital, three large hospitals seeing a variety of patients, and one large hospital providing care to primarily oncology patients. The goal was to review 15 inpatient and 15 outpatient charts of oncology patients (a total of 150 charts, 75 inpatient and 75 outpatient charts). The actual sample included a total of 119 charts, 82 inpatient charts and 37 outpatient charts. One of the data collectors was unable to find charts documenting pain in any cancer outpatients, and in two other hospitals fewer than 15 charts documenting pain in cancer patients were found. Pain intensity was noted in 57% of the charts, while treatment was noted in 86%. Reassessment after treatment was found in 50% of the charts. Little discharge planning noted pain management concerns (23% of charts), and almost no documentation (12%) of teaching or pain monitoring (30%) after operative or other procedures was found. In addition to the finding that no pain assessment was documented on many outpatients, when pain was assessed it was not done completely. These findings have been shared at each institution and various changes are being made to improve pain management and documentation. Work to properly manage cancer pain needs to continue, and the JCAHO standards provide another mechanism to evaluate practice and its documentation in order to improve care provided.en_GB
dc.date.available2011-10-27T14:35:14Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:35:14Z-
dc.conference.hostSouthern Nursing Research Societyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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