A Resource For Integrating the Revised JCAHO Pain Assessment and Management Standards

• Discusses the concept of “Pain as the Fifth Vital Sign” (p. 3).
• Provides a “Bill of Rights for People with Pain” (p. 13).
• Lists the available resources for professional education (p. 6) and clinical practice guidelines (p. 7).

• Uses a system-by-system approach to present research regarding the harmful effects of unrelieved pain (pp. 23-32).

• Uses an easily recognized icon to identify pediatric content.
• Addresses patient, caregiver, and institutional barriers to assessing and managing pain (pp. 36-58), including a section on assessing and documenting pain in challenging patients (pp. 89-99) and a barriers questionnaire designed to assess patients’ attitudes toward pain (p. 93).
• Offers strategies for improving communication about pain between members of the health care team, including the patient (pp. 84-89).
• Outlines a process for assessing all types of pain, including questions to ask during the routine admission assessment (pp. 58-62).
• Provides numerous reproducible tools for documenting and communicating pain, e.g., the Initial Pain Assessment Tool (p. 60), Brief Pain Inventory (p. 61), a variety of pain rating scales in several different languages (pp. 62-78), and inpatient and outpatient pain flow sheets (pp. 78-88).
• Explains the use of the comfort/function goal (p. 67) and how to teach patients to use the pain rating scale (p. 74).

• Uses an easily recognized icon to identify pediatric content.
• Presents the pharmacologic management of pain.
• Discusses key analgesic concepts, e.g., around the clock dosing (p. 175) and PCA (pp. 175-177).
• Provides:
  • Pain management protocols and guidelines (listed inside the book's cover).
  • Examples of reproducible patient educational materials regarding medications and therapies (pp. 126-127, 153-158, 277-292, 345-353), a patient teaching checklist (p. 273), and suggestions for discussing addiction with patients and families (pp. 275-276).
  • Suggestions for collecting and documenting an analgesic history (pp. 124-125).
  • Equianalgesic dose charts: Complete version (nonopioids/opioids, p. 133; opioids, p. 241) and laminated pocket size (free insert and reproducible copy available).
  • Reproducible assessment aids and documentation forms (pp. 124-127).
• Lists patient assistance programs (p. 194).

• Uses an easily recognized icon to identify pediatric content.
• Distinguishes between painful and nonpainful procedures (p. 365).
• Presents the pharmacologic and nonpharmacologic management of procedural pain.
• Provides procedural pain management protocols and guidelines (page references for appropriate boxes and tables are listed inside the front cover under COMMONLY USED FORMS, CHARTS, AND GUIDELINES, Procedural Pain), including a detailed conscious sedation protocol (pp. 382-384).

• Addresses misconceptions related to the use of nondrug approaches to managing pain (pp. 400-403)
• Provides guidelines and protocols for appropriate use of nondrug techniques (pp. 403-405; page references for appropriate boxes are listed inside the front cover under COMMONLY USED PATIENT INFORMATION FORMS AND BOXES, Nondrug Approaches to Pain Management.)
• Lists resources for clinicians and patients (pp. 423-425).

• Addresses barriers and misconceptions related to assessing and managing chronic nonmalignant pain (pp. 469-471).
• Provides:
  • Protocols and guidelines for pain assessment (pp. 477- 487; 491) and management (pp. 490-499; listed inside the book's cover) of patients with chronic nonmalignant pain, including discussion of suicide, depression, addiction, and long-term use of opioids in this patient population.
  • Reproducible assessment tools and documentation forms (pp. 478-485,.489, 508, 511-512).
  • Patient education tips and materials (pp. 494, 503-507), including helping patients set realistic goals (p. 490).
  • Guidelines for gathering information about pain management programs (p. 515).
• Lists resources for clinicians, patients, and families (pp. 516-520).

• Addresses misconceptions related to managing pain during pregnancy, childbirth, postpartum, and breast feeding (p. 610).
• Focuses on pharmacologic management of pain in patients during pregnancy, childbirth, postpartum, and breast feeding.
• Lists resources for clinicians and patients (pp. 611-612).

• Addresses barriers and misconceptions related to assessing and managing pain in infants (pp. 627- 631) and harmful effects of unrelieved pain in this population of patients (pp. 631-635).
• Provides:
  • Tips and reproducible tools for assessing (pp. 631-635, 639-651), documenting (p. 632), and managing (pp. 651-661) pain in infants, including an algorithm for NICU interventions (pp. 662-663).
  • Guidelines and protocols for managing pain in infants (p. 661; 664-667; page references for forms, tables, and boxes are listed inside the front cover under COMMONLY USED FORMS, CHARTS, AND GUIDELINES, Infants).
  • Clinician and family education tips (pp. 661-668).
• Lists resources for clinicians and families (pp. 668-669).

• Addresses barriers and misconceptions related to assessing and managing pain in the elderly (pp. 675-676).
• Discusses the idiosyncrasies of pharmacologic and nonpharmacologic pain management in the elderly (pp. 687-700).
• Provides:
  • A guide to selecting a long-term care facility (pp. 682-683).
  • Tips on assessing and managing pain in complex elderly patients, e.g., cognitively impaired (pp. 686,. 701-705), frail and debilitated (pp. 700-701).
• Reproducible tools for assessing pain and other conditions, e.g., confusion vs. dementia (p. 704) and alcoholism (p. 705) in the elderly.
• Lists resources for clinicians, patients, and families (pp. 684-685)

• Addresses barriers and misconceptions related to improving institutional pain management (pp. 712-713).
• Details the establishment of the interdisciplinary pain care committee, including composition (p. 716) and troubleshooting (pp. 718-720).
• Lists pain care committee responsibilities and activities directed toward building institutional commitment to improving pain management (pp. 731-733).
• Provides:
  • Tools to guide the work of the pain care committee, e.g., resources (p. 717); mission statement and ground rules (pp. 717-718); data analysis tools (pp. 721-723); institutional needs assessment (pp. 724-726); medical record audit (p. 727); knowledge and attitude survey (p. 728); patient questionnaire (p. 729).
  • Example institutional pain assessment and management standards (p. 734) and institutional pain management library (p. 738).
• Lists preceptorship and pain resource nurse programs (p. 741).
• Presents contributions and limitations of pain services, role model programs, pain resource nurse programs, and nurse-based PCA services (pp. 739-742).
• Discusses staff, physician, patient, and family education (pp. 734-738).