Pain and Satisfaction With Pain Management Among Older Patients During the Transition From Acute to Skilled Nursing Care

Simmons, Sandra F.; Schnelle, John F.; Saraf, Avantika A.; Coelho, Chris S.; Jacobsen, Jens Christian Brings; Kripalani, Sunil; Bell, Susan P.; Mixon, Amanda S.; Vasilevskis, Eduard E.

doi:10.1093/geront/gnv058

Cited by 17 publications

(13 citation statements)

References 38 publications

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“…Other samples of hospitalized individuals have been smaller, investigated specific analgesics (e.g., opioids), or included more heterogeneous groups (e.g., mixed age groups or combined medical and surgical patients). [34][35][36][37] Although the prevalence identified in our study (20%) was lower than estimates of pain in community-dwelling adults (24-72%), [2][3][4] it is likely that this difference is because we focused on moderate to severe pain, whereas other studies Figure 3. Flow chart of opioid prescription before hospitalization, during hospitalization, and at discharge.…”

Section: Discussioncontrasting

confidence: 67%

“…Our study offers a unique focus on management of moderate to severe pain in older medical patients. Other samples of hospitalized individuals have been smaller, investigated specific analgesics (e.g., opioids), or included more heterogeneous groups (e.g., mixed age groups or combined medical and surgical patients) . Although the prevalence identified in our study (20%) was lower than estimates of pain in community‐dwelling adults (24–72%), it is likely that this difference is because we focused on moderate to severe pain, whereas other studies reported any level of pain.…”

Section: Discussionmentioning

confidence: 59%

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Prevalence and Characteristics of Moderate to Severe Pain among Hospitalized Older Adults

Deng

Patel

Miaskowski

et al. 2018

J American Geriatrics Society

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 59%

Prevalence and Characteristics of Moderate to Severe Pain among Hospitalized Older Adults

Deng

Patel

Miaskowski

et al. 2018

J American Geriatrics Society

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“…These insights suggest that transitions of hospitalized individuals with PICCs to SNFs are not straightforward. Rather, in accordance with the literature, attention during transitions is needed to ensure that SNFs are able to provide the complexity of care that such individuals require.…”

Section: Discussionmentioning

confidence: 99%

Challenges for Nurses Caring for Individuals with Peripherally Inserted Central Catheters in Skilled Nursing Facilities

Harrod

Montoya

Mody

et al. 2016

J American Geriatrics Society

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Objectives To understand frontline nurses’ (registered nurses and licensed practical nurses), unit nurse managers’ and skilled nursing facility (SNF) administrators’ perceived preparedness in providing care for patients with peripherally inserted central catheters (PICCs) in SNFs. Design An exploratory, qualitative pilot study. Setting Two community based SNFs. Participants Patients, frontline nurses (registered nurses and licensed practical nurses), unit nurse managers and SNF administrators. Methods Over 36-weeks, we observed and conducted informal interviews with 56 patients with PICCs and their nurses focusing on PICC care practices and documentation. In addition, we collected baseline PICC data including placement indication (e.g., antimicrobial administration), placement setting (hospital vs. SNF), and dwell time. We then conducted focus groups with frontline nurses and unit nurse managers and semi-structured interviews with SNF administrators to evaluate perceived preparedness for PICC care. Data were analyzed using a descriptive analysis approach. Results During weekly informal interviews and observations variations in documentation were observed. Differences between patient-reported PICC concerns (quality-of-life) and those described by frontline nurses were noted. Deficiencies in communication between hospitals and SNFs with respect to device care, date of last dressing change and PICC removal time were also noted. During focus group sessions, perceived inadequacy of information at the time of care transitions, limited availability of resources to care for PICCs and gaps in training and education were highlighted as barriers in improving practice and safety. Conclusion Our study suggests that practices for PICC care in SNFs can be improved. Multimodal strategies that enhance staff education, improve information exchange during care transitions and increase resource availability in SNFs appear necessary to enhance PICC care and patient safety.

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“…45 A modified comprehensive assessment using any of these tools to identify causes, qualities, and severity of pain may be needed at discharge, and this information should be clearly documented and communicated during transitions of care. The presence of pain is demonstrated in cross-setting data from Simmons and colleagues 45 in which 51 % of older adults had moderate-to-severe pain before hospitalization, upon hospital discharge (38%), and after admission to a skilled nursing facility (53%).…”

Section: Pain Assessmentmentioning

confidence: 99%

Assessment and Measurement of Pain in Adults in Later Life

Booker¹,

Herr

2016

Clinics in Geriatric Medicine

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Summary Advancing age and multiple comorbidities heighten the risk of persistent pain in older adults. Therefore, assessment of persistent and acute pain is an important part of preventative and palliative health care in older adults. Using the techniques discussed in this article can assist providers in assessing pain and obtaining self-report from older adults. Box 1 provides a list of geriatric pain resources for readers interested in learning more about this topic.

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Pain and Satisfaction With Pain Management Among Older Patients During the Transition From Acute to Skilled Nursing Care

Cited by 17 publications

References 38 publications

Prevalence and Characteristics of Moderate to Severe Pain among Hospitalized Older Adults

Prevalence and Characteristics of Moderate to Severe Pain among Hospitalized Older Adults

Challenges for Nurses Caring for Individuals with Peripherally Inserted Central Catheters in Skilled Nursing Facilities

Assessment and Measurement of Pain in Adults in Later Life

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