Assessing and treating pain in hospices: current state of evidence-based practices

Keela Herr; Marita Titler; Perry  Fine; Sara Sanders; Joe  Cavanaugh; John Swegle; Chris Forcucci; Xiongwen Tang

doi:10.1016/j.jpainsymman.2009.09.025

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Assessing and treating pain in hospices: current state of evidence-based practices

Journal article

Open access

Peer reviewed

Assessing and treating pain in hospices: current state of evidence-based practices

Keela Herr, Marita Titler, Perry Fine, Sara Sanders, Joe Cavanaugh, John Swegle, Chris Forcucci and Xiongwen Tang

Journal of Pain & Symptom Management, Vol.39(5), pp.803-819

05/01/2010

DOI: 10.1016/j.jpainsymman.2009.09.025

PMID: 20471542

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Abstract

The aim of this study was to report on current provider evidence-based assessment and treatment practices for older adults with cancer in community-based hospice settings. Using the Cancer Pain Practices Index, a tool developed by the researchers to measure evidence-based pain management practices, patients received an average of 32% of those key evidence-based practices (EBPs) that were applicable to their situations. When examining individual practices, most of the patients had their pains assessed at admission using a valid pain scale (69.7%) and had primary components of a comprehensive assessment completed at admission (52.7%); most patients with admission reports of pain had an order for pain medication (83.5%). However, data revealed a number of practice gaps, including additional components of a comprehensive assessment completed within 48 hours of admission (0%); review of the pain treatment plan at each reassessment (35.7%); reassessment of moderate or greater pain (5.3%); consecutive pain reports of 5 or greater followed by increases in pain medication (15.8%); monitoring of analgesic-induced side effects (19.3%); initiation of a bowel regimen for patients with an opioid order (32.3%); and documentation of both nonpharmacological therapies (22.5%) and written pain management plans (0.6%). Findings highlight positive EBPs and areas for improving the translation of EBPs into practice. Data suggest that cancer pain is not being documented as consistently assessed, reassessed, or treated in a manner consistent with current EBP recommendations for older adults with cancer in community-based hospices.

Hospice Care

Nursing

Neoplasms -- Nursing

Pain Measurement -- Nursing

Pain -- Diagnosis

Pain -- Nursing

Age Factors

Aged

80 and Over

Analgesics -- Therapeutic Use

Analgesics

Opioid -- Therapeutic Use

Female

Guideline Adherence

Hospices

Human

Male

Medical Practice

Evidence-Based

Neoplasms -- Complications

Nursing Assessment

Pain Measurement -- Standards

Pain -- Etiology

Pain -- Therapy

Practice Guidelines

Questionnaires

Research

Resource Databases

Details

Title: Subtitle: Assessing and treating pain in hospices: current state of evidence-based practices
Creators: Keela Herr
Marita Titler
Perry Fine
Sara Sanders
Joe Cavanaugh
John Swegle
Chris Forcucci
Xiongwen Tang
Resource Type: Journal article
Publication Details: Journal of Pain & Symptom Management, Vol.39(5), pp.803-819
DOI: 10.1016/j.jpainsymman.2009.09.025
PMID: 20471542
NLM abbreviation: J Pain Symptom Manage
ISSN: 0885-3924
Grant note: DOI: 10.13039/100000054, name: National Cancer Institute, award: R01CA115363
Language: English
Date published: 05/01/2010
Academic Unit: Statistics and Actuarial Science; Liberal Arts and Science Admin; Nursing Administration and Gen; Biostatistics; School of Social Work; Nursing; Pharmacy Practice and Science; Injury Prevention Research Center
Record Identifier: 9983557131902771

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