Title
Pain Management In The Post-Acute And Long-Term Care Setting
Authoring Organization
Publication Month/Year
November 1, 2012
Last Updated Month/Year
October 17, 2024
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
This Pain Management CPG is not only about pain treatment but also about addressing the many questions and issues that influence—and are influenced by—pain management (e.g., patients with limited cognition and verbal communication, survey-related issues, opioid diversion, substance use disorders).
Target Patient Population
Patients in the post-acute and long-term care (PALTC) setting
Target Provider Population
Medical director, attending physicians, advanced practice clinicians, director of nursing, nursing staff, pharmacist, therapists, social workers, dietitians, and nursing assistants
PICO Questions
What is pain?
What is the prevalence of pain and conditions that predispose to pain?
What are some common challenges in managing pain?
What preparation/systems/processes does a facility need to support effective pain management?
When should routine and interim screening for pain be performed?
What are key elements of a medical practitioner/nurse assessment for pain?
How should we define and characterize an individual’s pain?
What are key aspects of documentation related to pain?
What are key elements of a physical assessment related to pain?
What are key considerations in diagnosing causes of pain?
What are key concepts and vocabulary related to discussing and managing pain?
What factors influence a pain management plan?
What are additional considerations for pain management in specific situations?
What are general considerations for prescribing analgesics?
What are the approaches to prescribing and administering as needed and standing doses of analgesics?
What are the pharmacological options for managing pain?
What are the indications, specific considerations, and challenges related to opioid analgesics?
When is a pain consultation indicated in managing pain, and how should the staff and practitioners interact with pain consultants?
What is the role of hospice in managing pain, and how should facilities and practitioners interact with hospice providers?
What should be monitored regarding pain and how should it be done?
How should decisions be made about changing, adding, or stopping analgesics?
How should a facility oversee and review its pain management approaches, including the use of opioids to treat pain?
How should a facility monitor for and address issues of opioid-related disorders in patients?
How should a facility monitor for and address issues of drug diversion among staff, residents, and others?
How should facilities and practitioners take into account nursing home regulations and surveys in managing pain?
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Long term care
Intended Users
Nurse, nurse practitioner, physician, physician assistant, social worker
Scope
Management
Keywords
Pain Management