Improving Pain Assessment Practices and Outcomes in Long-Term Care Facilities: A Mixed Methods Investigation

Implementation of Observational Pain Management Protocol for Residents With Dementia: A Cluster‐RCT

“…In the current study, the use of the Protocol did not have any effect on pain medications, a result similar to the findings in several previous studies . Conversely, another RCT showed a significant increase in the use of “as needed” pain medications among RWD after the regular use of an observational pain scale in the experimental homes .…”

“…Conversely, another RCT showed a significant increase in the use of “as needed” pain medications among RWD after the regular use of an observational pain scale in the experimental homes . Hadjistavropoulos et al's study showed that RWD in experimental homes were administered significantly fewer psychotropic medications after the regular use of their pain assessment protocol, even though no effect on the use of pain medications and on the observational pain scores had been identified as a result of the implementation of the pain assessment protocol.…”

“…A communication pathway between nursing home staff and physicians about the participants’ observational pain scores is embedded in the protocol of Hadjistavropoulos et al to ensure that physicians were aware of their clients’ observational pain score. Such a communication pathway was not emphasized in the current Protocol.…”

Pain Management in Nursing Home Residents: Findings from a Pilot Effectiveness‐Implementation Study

“…Unlike similar studies in the field of NH pain management, and despite our small sample size, this study showed significant changes in pain‐related outcomes . Chronic pain is common in NH residents; therefore, improving psychosocial and functional interference from pain is highly relevant to the affected residents' quality of life.…”

Evidence-based Development and Initial Validation of the Pain Assessment Checklist for Seniors With Limited Ability to Communicate-II (PACSLAC-II)

“…Specifically, long-term care (LTC) nurses report having difficulty accurately identifying pain in their residents with dementia. 17,18 Finally, the PACSLAC is the only tool of its kind that comprehensively covers all 6 domains of nonverbal behaviors deemed to be important for pain assessment in this population by the American Geriatric Society ([AGS] ie, facial expressions, verbalizations and vocalizations, body movements, changes in activity patterns and routines, changes in interpersonal interactions, and mental status changes). [4][5][6][7][8] To address the undermanagement of pain, the past decade saw the development of numerous observational pain assessment tools for more systematic identification of pain in older persons with dementia.…”