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An Evidence‐Based Program to Improve Analgesic Practice and Pain Outcomes in Residential Aged Care Facilities
Author(s) -
Savvas Steven M.,
Toye Chris M.,
Beattie Elizabeth R. A.,
Gibson Stephen J.
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12935
Subject(s) - medicine , analgesic , pain assessment , physical therapy , pain management , activities of daily living , workforce , dementia , minimum data set , scale (ratio) , pain scale , nursing , nursing homes , psychiatry , economics , economic growth , physics , disease , quantum mechanics
Pain is common in individuals living in residential aged care facilities ( RACF s), and a number of obstacles have been identified as recurring barriers to adequate pain management. To address this, the Australian Pain Society developed 27 recommendations for comprehensive good practice in the identification, assessment, and management of pain. This study reviewed preexisting pain management practice at five Australian RACF s and identified changes needed to implement the recommendations and then implemented an evidence‐based program that aimed to facilitate better pain management. The program involved staff training and education and revised in‐house pain‐management procedures. Reviews occurred before and after the program and included the assessment of 282 residents for analgesic use and pain status. Analgesic use improved after the program ( P < .001), with a decrease in residents receiving no analgesics (from 15% to 6%) and an increase in residents receiving around‐the‐clock plus as‐needed analgesics (from 24% to 43%). There were improvements in pain relief for residents with scores indicative of pain, with Abbey pain scale ( P = .005), Pain Assessment in Advanced Dementia Scale ( P = .001), and Non‐communicative Patient's Pain Assessment Instrument scale ( P < .001) scores all improving. Although physical function declined as expected, Medical Outcomes Study 36‐item Short‐Form Survey bodily pain scores also showed improvement ( P = .001). Better evidence‐based practice and outcomes in RACF s can be achieved with appropriate training and education. Investing resources in the aged care workforce using this program improved analgesic practice and pain relief in participating sites. Further attention to the continued targeted pain management training of aged care staff is likely to improve pain‐focused care for residents.