Time to analgesia and pain score documentation best practice standards for the Emergency Department – A literature review

Hatherley, Claire; Jennings, Natasha; Cross, Rachel

doi:10.1016/j.aenj.2015.11.001

Cited by 50 publications

(62 citation statements)

References 26 publications

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“…Despite median wait times to analgesia, which, at 87.5 min, were significantly higher than suggested best practice of 30 min and exceeded National Pain Management Initiative pre‐ and post‐intervention mean times to analgesia of 61 and 41 min, respectively, mean satisfaction ratings remained consistently high in our study.…”

Section: Discussioncontrasting

confidence: 72%

Association between pain control and patient satisfaction outcomes in the emergency department setting

Brown

Shetty

Zhao

et al. 2018

Emerg Medicine Australasia

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Section: Discussioncontrasting

confidence: 72%

Association between pain control and patient satisfaction outcomes in the emergency department setting

Brown

Shetty

Zhao

et al. 2018

Emerg Medicine Australasia

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“…Although 80% of obstetric patients and 69.5% of orthopedic patients confirmed that their pain was assessed prior to pain medication administration, documentation of that pain assessment was only completed in 5% of obstetric patients and 6.8% of orthopedic patients. Similarly, multiple studies on pain management have shown that documentation of pain assessment was not consistently done for the majority of patients [42–45]. Despite guidelines underpinning pain assessment as the cornerstone of pain management and its documentation as an essential tool to make pain more discernible, pain intensity documentation remains suboptimal [45, 46].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, multiple studies on pain management have shown that documentation of pain assessment was not consistently done for the majority of patients [42–45]. Despite guidelines underpinning pain assessment as the cornerstone of pain management and its documentation as an essential tool to make pain more discernible, pain intensity documentation remains suboptimal [45, 46]. This calls for healthcare institutions to implement policies and procedures mandating continuous pain assessment and documentation.…”

Section: Discussionmentioning

confidence: 99%

Patient Perception of Acute Pain Management: Data from Three Tertiary Care Hospitals

Ramia

Nasser

Salameh

et al. 2017

Pain Research and Management

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Introduction. The primary objectives of this study were to assess patients' description of their acute pain intensity; patients' attitude towards their pain management during hospitalization; and their overall satisfaction with pain treatment. Methodology. A cross-sectional questionnaire-based study was conducted between October 2014 and March 2015 in three medical centers in Lebanon. All participants' responses were reported using descriptive statistics. The association between categorical variables was evaluated using Pearson χ2 test or Fisher's exact test where the expected cell count was < 5. Results. A total of 119 women on the maternity services and 177 patients on the orthopedic services were surveyed. Around 50% of obstetric and 37% of orthopedic patients reported pain to be severe at its highest intensity. In maternity and orthopedic patients, respectively, unfavorable practices included pain not being assessed prior to pain medication administration (19.3% and 30.5%), having to wait for ≥30 minutes before getting the pain medication (14.2% and 11.3%), and pain score not being documented on medical chart (95% and 93.2%). Surprisingly, 94.1% of the maternity and 89.2% of orthopedic patients were satisfied to strongly satisfied with their pain management. Conclusion. Pre- and postoperative pain remain a prevalent problem that requires a consensus and joint efforts for improvement.

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“…Evidence‐based practice guidelines for the assessment of acute pain have been released by multiple bodies, including the Joint Commission on the Accreditation of Healthcare (JCAHO) , the Agency for Health Care Policy and Research (AHCPR) and the American Pain Society (APS) . Although pain assessment practices have been recognised internationally as one of the key quality indicators for geriatric emergency care , there is evidence that the implementation of pain assessment and re‐assessment continues to be variable and inadequate among elderly trauma populations . This becomes particularly challenging among those with cognitive impairment, dementia or delirium, when commonly used self‐report assessment tools are often uninformative .…”

Section: Methodsmentioning

confidence: 99%

Regional nerve blockade for early analgesic management of elderly patients with hip fracture – a narrative review

et al. 2017

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Elderly patients with hip fracture experience high morbidity and mortality, and are often undertreated for pain. Acute pain management in the elderly is challenging, with physiological frailty, medical comorbidities and cognitive impairment commonly compounding pain assessment and treatment. Guidelines outlining current best practice for acute pain management in the elderly now exist, but evidence suggests that practice remains variable and there continues to be scope for improvement. We conducted a narrative review of the literature to examine the challenges of acute pain management in the elderly, and to evaluate evidence for the role of regional nerve blocks for acute pain associated with hip fracture in the elderly. There is consistent evidence that regional nerve blocks can effectively reduce pain associated with hip fracture, providing rapid-onset, site-specific analgesia that is more effective than standard systemic analgesia alone. There is also moderate evidence that nerve blocks may contribute to reduced rates of delirium, and some suggestion of reduced length of inpatient stay, morbidity and mortality, although limited evidence is available. Fascia iliaca blocks are emerging as a block of choice, with evidence they can be safely and rapidly administered under ultrasound guidance in the acute setting, by both trained medical and nursing staff, with good effect. Ideally, comprehensive pain protocols for elderly hip fracture patients are required, that integrate evidence-based fascia iliaca block use, timely and repeated pain assessment, and multidisciplinary orthogeriatric patient care.

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Time to analgesia and pain score documentation best practice standards for the Emergency Department – A literature review

Cited by 50 publications

References 26 publications

Association between pain control and patient satisfaction outcomes in the emergency department setting

Association between pain control and patient satisfaction outcomes in the emergency department setting

Patient Perception of Acute Pain Management: Data from Three Tertiary Care Hospitals

Regional nerve blockade for early analgesic management of elderly patients with hip fracture – a narrative review

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