Daily Pain That Was Excruciating at Some Time in the Previous Week: Prevalence, Characteristics, and Outcomes in Nursing Home Residents

Teno, Joan M.; Kabumoto, Glen; Wetle, Terrie; Roy, Jason; Mor, Vincent

doi:10.1111/j.1532-5415.2004.52215.x

Cited by 111 publications

(64 citation statements)

References 32 publications

(51 reference statements)

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“…Research indicates that as many as 83% of nursing home residents experience pain that often goes unrecognized or inappropriately treated (AGS Panel, 2002;Teno, Kabumoto, Wetle, Roy, & Mor, 2004;Zanocchi et al, 2007). This is significant in that the presence of persistent pain adversely affects mood, sleep quality, functional ability, and quality of life (AGS Panel, 2002;Leong & Nuo, 2007).…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of pressure ulcers, malnutrition, and incontinence remains at unacceptable levels (IOM, 2001;Weiner et al, 2007). Of particular concern is the high number of nursing home residents who experience pain (AGS Panel on Persistent Pain in Older Persons [AGS Panel], 2002;Gibson, 2007;Zanocchi et al, 2007).Research indicates that as many as 83% of nursing home residents experience pain that often goes unrecognized or inappropriately treated (AGS Panel, 2002;Teno, Kabumoto, Wetle, Roy, & Mor, 2004;Zanocchi et al, 2007). This is significant in that the presence of persistent pain adversely affects mood, sleep quality, functional ability, and quality of life (AGS Panel, 2002;Leong & Nuo, 2007).…”

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Nursing Home Staff Adherence to Evidence-Based Pain Management Practices

Jablonski¹,

Ersek²

2009

J Gerontol Nurs

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The purpose of this study was to determine the extent to which nursing home staff adhere to current evidence-based guidelines to assess and manage persistent pain experienced by elderly residents. A retrospective audit was conducted of the medical records of 291 residents of 14 long-term care facilities in western Washington State. Data revealed a gap between actual practice and current best practice. Assessment of persistent pain was limited primarily to intensity and location. Although prescribing practices were more in line with evidence-based guidelines, a significant number of residents did not obtain adequate pain relief. Nonpharmacological pain management methods were rarely implemented. Nursing home staff and administrators must critically examine both system and individual staff reasons for failure to comply with best pain management practices. Research is needed to determine factors that contribute to less-than-optimal adherence to evidence-based guidelines for pain management, as well as the best methods for implementing practice change.The quality of care provided in U.S. nursing homes has long been a concern of policy makers, health care providers, and consumers. Following a study conducted in 1986, the Institute of Medicine (IOM) concluded that care provided in nursing homes was often seriously inadequate. These findings provided the impetus for enactment of the Omnibus Budget Reconciliation Act of 1987, which established higher standards of care for nursing homes receiving Medicare and Medicaid funding. Although the quality of care in nursing homes improved after this legislation went into effect, it is well known that care remains less than optimal in many instances (Weiner, Freiman, & Brown, 2007). The prevalence of pressure ulcers, malnutrition, and incontinence remains at unacceptable levels (IOM, 2001;Weiner et al., 2007). Of particular concern is the high number of nursing home residents who experience pain (AGS Panel on Persistent Pain in Older Persons [AGS Panel], 2002;Gibson, 2007;Zanocchi et al., 2007).Research indicates that as many as 83% of nursing home residents experience pain that often goes unrecognized or inappropriately treated (AGS Panel, 2002;Teno, Kabumoto, Wetle, Roy, & Mor, 2004;Zanocchi et al., 2007). This is significant in that the presence of persistent pain adversely affects mood, sleep quality, functional ability, and quality of life (AGS Panel, 2002;Leong & Nuo, 2007). From a systems perspective, the high prevalence of pain is a Address correspondence to Anita Jablonski, PhD, RN, Assistant Professor, Seattle University College of Nursing, 901 12th Avenue, PO Box 222000, Seattle, WA 98122-1090; jablonsk@seattleu.edu.. The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity. 2003). The guidelines synthesize current best practice through integration of scientific evidence, clinical experience, and expert opinion. These resources can potentially increase the effe...

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Nursing Home Staff Adherence to Evidence-Based Pain Management Practices

Jablonski¹,

Ersek²

2009

J Gerontol Nurs

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“…6 Undertreated pain in nursing homes is well documented, 5 and roughly 4 percent of residents experience daily pain that is excruciating. 7 Pneumonia, infection, eating problems, and tube feeding are common and associated with high six-month mortality, distressing symptoms, and a high risk of hospitalization and medical intervention. 4 …”

Section: Standardizing Palliative Care In Nursing Homes: a Novel And mentioning

confidence: 99%

Raising The Standard: Palliative Care In Nursing Homes

2010

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More than two-thirds of long-stay nursing home residents suffer from dementia. This illness has a variable and unpredictable course that renders it a poor fit for the six-month life-expectancy requirement of the Medicare hospice benefit. Palliative care-a form of treatment that strives to match care to patient goals, relieve pain, and improve quality of life for people with chronic or life-threatening illnesses-should be the standard of practice for all elderly dementia patients in nursing homes, regardless of prognosis. Similar principles could apply to other long-term residents with underlying chronic diseases who would benefit from palliative care. Indeed, we would argue that the growing acceptance of the culture-change movement centered on elder-directed goals in nursing homes is promising evidence of the goodness-of-fit of palliative care principles in the long-term care setting. M ore than 70 percent of longstay residents in nursing homes are elderly and have moderate-to-severe dementia.

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“…The prevalence of pain in patients living in nursing homes and community care is even higher (27.8%-86.5%). The highest rates are reported by patients who are able to self-report their pain (McClean & Higginbotham, 2002;Nygaard & Jarland, 2005;Takai, Yamamoto-Mitani, Okamoto, Koyama, & Honda, 2010;Teno, Kabumoto, Wetle, Roy, & Vincent, 2004;Torvik, Kaasa, Kirkevold, & Rustøen, 2009;Weiner & Hanlon, 2001). Torvik et al found a higher rate of pain among nonverbal patients when using the Doloplus-2, an observation-based pain assessment tool compared with self-reporting by patients in nursing homes.…”

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confidence: 99%

Pain Assessment Strategies in Home Care and Nursing Homes in Mid-Norway: A Cross-sectional Survey

Torvik¹,

Nordtug²,

Brenne³

et al. 2015

Pain Management Nursing

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The prevalence of pain ranges from 27.8% to 86.5% in nursing homes and 42% to 50% in home care. Pain assessment is the first step toward effective pain management. The aim of this study was to explore the use of pain assessment strategies (verbal, numeric, and observation rating scales and standardized questions) in home care and nursing homes. The study was a descriptive cross-sectional survey. Health care providers who were responsible for the patients' medications replied to a questionnaire. In-home care and nursing homes in 11 randomly selected municipalities in Mid-Norway were included. Three hundred ninety-two individuals were included in this study (70% response rate): 271 (69%) from nursing homes and 121 (31%) from home care. The respondents working in home care had a higher educational level than those in working in nursing homes. Pain assessment instruments were not used frequently in nursing homes and home care. Verbal and numeric rating scales were used significantly more frequently in home care than in nursing homes. Registered nurses (RNs) in nursing homes used standardized questions significantly more often than did RNs in home care. RNs and social educators in home care self-reported less competence in treating the patients' total pain experience than did those in nursing homes. Workplace (working in home care) and regular training in the use of pain assessment tools explained more than 20% of the variation in the use of pain assessment tools. Regular training in the use of pain assessment tools is needed for health care workers in home care and nursing homes.

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Daily Pain That Was Excruciating at Some Time in the Previous Week: Prevalence, Characteristics, and Outcomes in Nursing Home Residents

Abstract: NH residents with daily pain that was sometimes excruciating were younger and seriously ill with functional decline and weight loss. Too often, persons remain in this level of pain.

Cited by 111 publications

References 32 publications

Nursing Home Staff Adherence to Evidence-Based Pain Management Practices

Nursing Home Staff Adherence to Evidence-Based Pain Management Practices

Raising The Standard: Palliative Care In Nursing Homes

Pain Assessment Strategies in Home Care and Nursing Homes in Mid-Norway: A Cross-sectional Survey

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