No Need for Pain

Abstract

In an attempt to promote as pain free an experience as possible for patients and to improve how pain is managed in all settings, this 500-bed teaching hospital embarked on a hospital-wide quality improvement (QI) initiative. Initial measurement of clinicians' knowledge and attitudes related to pain and surveys on patient satisfaction identified improvement opportunities. Highlights of these findings and the major interventions taken are described. Education of all clinical staff on the major principles of pain management became the primary focus. Major outcomes realized to date have been: (a) a significant increase (p = .01) in physicians and nurses discussing with their patients the importance of managing their pain, (b) development of processes for documenting pain as the fifth vital sign, and (c) a 26% decrease in the use of meperidine. The next steps will be comprehensive monitoring of the effectiveness of pain management by clinical service, increased patient and family education on pain, and development of a formalized pain management competency program for clinical staff.

National trends in long‐term use of prescription opioids

“…The trend may reflect a change in practice style of physicians who may have become more attentive to complaints of pain and may have lowered the threshold for prescribing opioids for management of pain . Concerns about poor management of pain in the past, “pain as the fifth vital sign” campaign, and direct to consumer advertising of pharmaceuticals may have also contributed to the change in physician practice styles and perhaps increased patient demands for opioid medications …”

“…3 Concerns about poor management of pain in the past, "pain as the fifth vital sign" campaign, and direct to consumer advertising of pharmaceuticals may have also contributed to the change in physician practice styles and perhaps increased patient demands for opioid medications. 39 Several limitations of the study should be considered in interpreting its results. First, it is not possible to assess the appropriateness of opioid treatment based on NHANES data.…”

Epidemiology of Regular Prescribed Opioid Use: Results from a National, Population-Based Survey

“…17 The “pain as the fifth vital sign” campaign initiated by the American Pain Society and implemented by organizations such as the Veterans Health Administration and Joint Commission on Accreditation of Health Care Organizations has increased routine assessment of pain. 18 …”

Assessment of intraoperative pain during Mohs micrographic surgery (MMS): An opportunity for improved patient care

“…Pain has been referred to as the fifth vital sign, 1 and the assessment of pain is commonplace during inpatient hospitalization. However, standardized pain assessment is not universal in health care, including in the outpatient surgery setting.…”