Implementing and sustaining evidence-based practices in long-term care.

Pain Assessment and Management

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    The guideline contains recommendations for best nursing practices in the assessment and management of pain for Registered Nurses (RNs) and Registered Practical Nurses (RPNs). It is acknowledged that the individual competency of nurses varies between nurses and across categories of nursing professionals (RNs and RPNs) and is based on knowledge, skills, attitudes, critical analysis and decision making which is enhanced over time by experience and education. This guideline is endorsed by the International Association for the Study of Pain.

    Registered Nurses’ Association of Ontario. (2013). Assessment and management of pain. (3rd Ed.). Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/AssessAndManagementOfPain_15_WEB-_FINAL_DEC_2.pdf

     

     

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    Pain Gap Analysis

    Organizational assessment tool to assist with implementation and evaluation of the RNAO Assessment and Management of Pain by comparing current practice to evidence-based practice. Source: Registered Nurses' Association of Ontario's Long-Term Care Best Practices Program, Toronto, ON. January 2014.

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    This link takes you to a workbook, with a goal to give LTC health care professionals the information and resources they need to improve systems essential for managing pain for residents. The workbook will as assist LTC homes in advancing the quality of pain management services and clinical outcomes for residents.

    The material was prepared by Masspro, the Medicare Quality Improvement Organization for Massachusetts, under contract with the Centres for Medicare & Medicaid Services (CMS), an agency of the US Department of Health and Human Services.

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    Abbey Pain Scale is an assessment tool for the measurement of pain in people with dementia who cannot verbalize

    Source: Dementia Care Australia Pty Ltd. Website: www.dementiacareaustralia.com

    Reference: Abbey, J; De Bellis, A; Piller, N; Esterman, A; Giles, L; Parker, D and Lowcay, B. Funded by the JH & JD Gunn Medical Research Foundation 1998 – 2002 (This document may be reproduced with this acknowledgment retained)Retrieved from: http://www.wales.nhs.uk/sitesplus/documents/862/FOI-286f-13.pdf

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    The website provides access to resources for those people with neuropathic pain.

    Website: http://www.actionontario.ca/

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    An assessment tool that uses the mnemonic OPQRSTUV to assist health care professionals systematically assess people who screen positively for the presence or risk of any type of pain and who can self report.

    Figure 1 (page 21) RNAO BPG Assessment and Management of Pain 3rd Edition (2012) http://rnao.ca/bpg/guidelines/assessment-and-management-pain

    Adapted from "Symptom Assessment Acronym "OPQRSTUV", in Fraser Health Authority, 2012, Hospice Palliative Care Program Symptom Guidelines. Retrieved from http://www.fraserhealth.ca/home/

     

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    This link will take you to the document developed by AdvantAge Ontario to support program objectives, policy, procedures and staff training materials and tools that meet minimum requirements of the LTCH Act and Regulation.

    Retrieved from www.advantageontario.com 

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    A succinct, 2-page newsletter that covers myths and facts about pain. Developed by the BPG in LTC Initiative Central South and The Long Term Care Resource Centre, Hamilton, Ontario.  Source: http://www.rgpc.ca/
     

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    Purpose of the BPI tool is to assess the severity of pain and the impact of pain on daily functions. The tool can be used for patients with pain from chronic diseases or conditions such as cancer, osteoarthritis and low back pain, or with pain from acute conditions such as postoperative pain.

    Assessment areas included are severity of pain, impact of pain on daily function, location of pain, pain medications and amount of pain relief in the past 24 hours or the past week.

    The BPI copyright is held by Dr Charles S. Cleeland (1991). The copyright applies to the BPI and all it's derivatives in any language.

    Retrieved from http://www.mdanderson.org/

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    This resource commences with access to many tools for screening, selection, monitoring and tapering for safe and effective use of opiods for chronic non-cancer pain. The resource then provides recommendations for opioid use in Canada in great detail, which will be of interest to physicians, nurse practitioners and other clinicians.

    Reference: National Opiod Use Guidelines Group (2010), Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain Practice Toolkit. Retrieved from http://nationalpaincentre.mcmaster.ca/opioid/