Clinical Pain Management

Barbara Acello, MS, RN

Identify, assess, and treat resident pain in your nursing home

The guidance you need to manage resident pain at your facility

This comprehensive resource helps clinicians to identify, assess, and treat resident pain using procedures that comply with CMS regulations. Written from a clinical perspective, this book and CD-ROM answers any question a nurse or administrator may have about incorporating effective pain management into resident care plans.

At 250 pages, this resource gives you:

• Clinical procedures to recognize and assess pain including how to develop an effective care plan
• A jam-packed CD-ROM that features more than 10 different pain scales and over 50 additional resources on pain
• Descriptions of different pain treatments, side effects, and protocols
• Insight into what CMS surveyors look for under F309 and tips to ensure compliance on survey day

Here are some of the tools included on the CD-ROM:

• Behavioral Pain Assessment
• Example Bowel Regimen to Prevent Opioid Constipation
• Nursing Comfort Measures and Other Potential Care Plan Interventions
• Fixed Combination Analgesic Examples
• Medication Agreement
• Pain Flow Sheet
• Pain Management Licensed Nurse Competency Guidelines
• Pain Management in Long Term Care Sample Policy
• Pain Assessment and Management Audit
• Chart Review Tool for Monitoring Quality Indicators Effective

Chapter 1: Introduction to Pain Management in the Long-Term Care Facility
Introduction to Pain
Definitions Associated with Pain in Long-Term Care Residents
Pain in Elderly Persons
Effects and Results of Pain
Pain and Depression
Other Barriers to Pain Identification and Management
Quality of Life
Nursing Responsibilities
What Matters
Establishing a Pain Management Program
It Takes a Village

Chapter 2: Pain Assessment
Pain Assessment
Pain Screening
Pain Recognition and the Role of the Nurse Assessor
The Initial Pain Assessment
Nursing Physical Assessment
Residents with Behavior Problems
Nursing Response to Residents Who Are Having Pain

Chapter 3: The Plan of Care
The Plan of Care
Care Plan Format
Formulating a Nursing Diagnosis
Care Plan Approaches
Nursing Comfort Measures and Other Potential Care Plan Interventions
Detrimental Effects of Noise
Alternative and Complementary Approaches
Care Plan Review and Revision Due to Changes

Chapter 4: Pain Treatment Protocols and Guidelines
Selection of Treatments
Treatment Resources and Guidelines to Assist Facilities
Nursing Concerns
Monitoring and Reporting
The Plan
Titration: The Principle
Other Considerations
Categorizing the Residents
Nursing Responsibilities in Pain Management
Pitfalls and Problems to Consider
Changing Drugs

Chapter 5: Pain Management and Oral Drugs
Age-Related Changes Affecting Pharmacologic Intervention
Initiating an Analgesic Regimen Using the WHO Ladder
Caring for Residents with Mild Pain
Drugs for Moderate Pain
Drugs for Severe Pain

Chapter 6: Pain Management and Other Methods of Administration
Changing from Oral Medication to a Transdermal Delivery System
Fentanyl Diversion
Topical Analgesics
Cobroxin(TM)
Pain and Spasticity Management

Chapter 7: Side Effects and Complications of Analgesia
Side Effects of Analgesics
Acetaminophen Toxicity
Analgesic Nephropathy
Pseudoaddiction
Tolerance and Dependence

Chapter 8: Special Situations and Populations
The Nursing Assistant's Perspective
Palliative Care
Residents with a History of Addiction or Substance Abuse
Pediatric Pain Management
Pain Contracts

Chapter 9: Quality of Care and Regulatory Compliance
Quality Assurance
Aggregate of Care Issues
F309, Quality of Care
Compliance with F309
Survey
Quality Improvement