Pain Management Nancy St. Sauver, RN, MA Lac Qui Parle Health Network Minnesota Long Term Care Medicine – 2011  March 24-27, 2011  Tampa, Florida

Faculty Disclosures: Nancy St. Sauver has disclosed that she has no relevant financial relationship(s).

Consortium Demographics Lac Qui Parle Health Network Appleton Area Health Services Johnson Memorial Health Services Madison Lutheran Home

Learning Objectives: By the end of the session, participants will be able to: Identify staff educational requirements to understand the importance of pain management. Recognize the effects of chronic pain Identify the components of assessing pain Understand how alternative treatments can improve pain management

The starting point Minnesota Quality Indicator Report Residents with moderate to severe pain Consortium member facilities received poor scores 2-year project Goal – improve score of residents with moderate to severe pain by 20% over the term of the project

Methodology Education Assessment Interventions Physicians Residents Families Nursing Home Staff Assessment Interventions

Education Barriers to recognizing pain Myths in pain management Chronic pain misconceptions Cultural and social barriers Effects of chronic pain 3 R’s Recognize Report Respond

Assessment Baseline/history Cognitively intact Cognitively impaired Interference with daily activities

Baseline/history Diagnoses related to pain Usual manner of expressing pain Interventions used in the past Success or Failure of past interventions

Cognitively Intact Assessment Manner of expressing pain Symptoms related to pain Pain medication Location Onset Frequency Description of pain Causes of pain Methods of relieving pain

Cognitively Impaired Assessment Observation and Listening Breathing Vocal Sounds Facial Expression Body Language

Interference with Daily Activities Getting into bed Turning in bed Transferring bed to chair/chair to bed Sitting in chair Dressing Eating Standing Walking Bathing

Interventions Pain medication Alternative treatments Warmth Cold Music Positioning Massage Aromatherapy

Results Goal: 20% Improvement Results: 36% Improvement

Questions? ???