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JCAHO Pain Standards and Hot Line

The pain standards are available from www.jcaho.org/standard/pm_hap.html. Scoring of the standards began in 2001. Under the new standards, health care providers are expected to be knowledgeable about pain assessment and management, and facilities are expected to develop policies and procedures supporting the appropriate assessment of pain and the use of analgesics and other pain control interventions. Some key concepts include:

• recognize the right of patients to appropriate assessment and management of pain
• assess the existence and, if so, the nature and intensity of pain in all patients
• record the results of the assessment in a way that facilitates regular reassessment and follow-up
• determine and assure staff competency in pain assessment and management, and address pain assessment and management in the orientation of all new staff
• establish policies and procedures which support the appropriate prescription or ordering of effective pain medications
• educate patients and their families about effective pain management
• address patient needs for symptom management in the discharge planning process
• maintain a pain control performance improvement plan

In terms of pain measurement, the standards include the following statement. "An organization selects pain intensity measures to ensure consistency across departments, for example, the 0-10 scale, the Wong-Baker FACES pain rating scale (smile-frown), and the verbal descriptor scale. Adult patients are encouraged to use the 0-10 scale. If they cannot understand or are unwilling to use it, the smile-frown or the verbal scale is used."

JCAHO has also established a toll free hot line (800-994-6610) to encourage patients, their families, caregivers and others to share concerns regarding quality of care issues, such as pain management, at accredited health care organizations. Complaints (can be anonymous) may be sent by email to complaint@jcaho.org; faxes to the office of Quality Monitoring at 630-792-5636; mail to the Office of Quality Monitoring, Joint Commission, One Renaissance Blvd, Oakbrook Terrace, IL, 60181.

Resources

Excellent resources for help in meeting the pain standards are:

Pain Assessment and Management: An Organizational Approach and an interactive CD-ROM for clinical staff development, Pain Management, are available from the Joint Commission.

Building an Institutional Commitment to Pain Management: The Mayday Resource Manual for Improvement.. An excellent compilation of resource material to promote institutional support of pain management; all of the sample resource tools are available on a disc. Available from American Alliance of Cancer Pain Initiatives, 1300 University Avenue, Madison, WI 53706; 608-265-4013, Fax 608-265-4014; Email: aacpi@aacpi.org; www.aacpi.org.

1. McCaffery M and Pasero C: Pain: Clinical Manual, 2nd edition, St. Louis, Mosby, 1999.

References

1. Acello B: Meeting JCAHO standards for pain control, Nursing 2000 30(3):52-54, 2000.
2. Pasero C, Gordon DB, and McCaffery M: JCAHO on assessing and managing pain, Am J Nurs 99(7):22, 1999.

Additional Information

• Bibliography: JCAHO Pain Standards: Implications for Practice
• FACES Permission Form
• FACES Translations
• FACES Research Summary
• Young Children's Pain & FACES
• Pain Assessment Record
• FYI 0 - 5 or 0 - 10 Coding for Wong-Baker FACES Pain Rating
• Selected Resources On Pain
• Websites Related to Pain and End of Life Care
• See Chapter 26 in Nursing Care of Infants and Children, 6th edition.
• See Chapter 21 in Essentials of Pediatric Nursing, 6th edition.

December 23, 2002

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