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Strategies for Pain Cheat Sheet by

Strategies for Pain
care     healthcare     pain     strategies     impact


A key area of concern within the IMPACT (Improving Medicare Post-Acute Transf­orm­ation) act is that of preventing pain and allevi­ating suffering occurring in older adults in skilled nursing facili­ties. The Nursing Home Quality Improv­ement Campaign provides ongoing reporting on state and national rates of Quality Measures, including the rate for residents self-r­epo­rting moderate to severe pain.

Strategy #1: Pain is everyone’s business.

As such, it should not be considered inform­ation only for the nurse. The Nursing Assistant or any helpful staff member can assist with offering a pillow, dimming the lights, offering a glass of water and then notifying the nurse of the need for a medication

Strategy #2: Pain is a partne­rship w/patient

What level of pain is tolerable for the patient? [Facility Name] has establ­ished a standard that a score of 5 or higher results in action, including a call to the provider if the medication is not effective.

Strategy #3 Pain Meds & Nonpha­rma­col­ogical

Pain medica­tions work better when nonpha­rma­col­ogical strategies are used.

The use of a calm and quiet enviro­nment can promote the effect­iveness of medica­tions. Dimming room lights, reducing noise levels can help promote comfort and give the medication time to work more effect­ively.

Strategy #4: Pain Scheduling analgesic medica­tions

Pain Management strategies work best when the patient doesn’t have to ask for them.

Scheduling analgesic medica­tions around the clock (while awake) is a best practice. Antici­pating pain through hourly rounding, offering reposi­tio­ning, hydration and toileting will go far in promoting comfort.


Strategy #5: Pain strategies Same Playbook

Pain strategies work better when we are all using the same playbo­ok.

Consistent messaging is essential. Some patients are expected to encounter pain with activity, yet the avoidance of activity will result in loss of function. Medicating prior to Therapy and assuring that the patient unders­tands that reducing activity will result in loss of function, which is not a good outcome, are key strate­gies. It is critical that the patient understand that sometimes Therapy will be uncomf­ort­able, and that the team will work hard to make sure that the patient is as comfor­table as possible, while still making gains in Therapy.

Care Plans for Pain

Care Plans for pain should include indivi­dua­lized perspe­ctives for the patient on their expect­ations for pain manage­ment, including incorp­oration of the above strate­gies. Interv­entions for pain management should include the full team with creative and non-ph­arm­aco­logical methods included in the discus­sion.

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