2. Pain Management Education: Patients as Partners

3. Pain Management Education Patients as Partners Objectives 1.Learners will gain knowledge of the movement that brought pain to the forefront. 2.Learners will discuss myths, misconceptions and barriers to proper pain management. 3.Participants will gain knowledge of patient/provider communication strategies to properly assess and treat pain

4. Pain to the Forefront 1999 JCAHO* develops and publishes pain standards 2000 standards take effect 2001 American Pain Society introduces National Pain Care Policy Act 2003 VA National Strategy: Pain is 5th Vital Sign

5. Painful Facts Pain Action Guide, American Pain Foundation, 2000 More than 50 million Americans suffer from chronic pain Each year, another 25 million Americans experience pain as a result of injury or surgery

6. Assess your own practice  How much time allotment for pain assessment and education?  Who is your target population(s) e.g. elderly, peds, chronic conditions?  What are your patients beliefs, cultures and education level?  Who does the assessment and education (e.g. physician, nurses, NP, PA)?

7. Assess your own practice  What are you currently using to assess pain and required education?  How are you documenting pain assessment and education.  What educational resources are used?

8. Patient Education Resources Survey Results  80% Print materials developed by their  healthcare center  40% MicroMedex  30% Association-provided  20% Purchased Booklets  20% Pharmaceutical Company materials

9. Managing Pain: there’s lots to gain Purpose of tool Meet JCAHO requirements Address key patient issues Address key provider issues

10. Managing Pain: there’s lots to gain Development of educational tool Determining key educative points: providers and patients Produce video Evaluate effectiveness

11. Top 10 Content Points Pain Management Education (survey results: providers) 1. Importance of reporting pain 2. Communicating pain 3. Pain scale 4. Benefits of pain management 5. Goals and expectations of pain management 6. Patients rights 7. Dispelling myths 8. Different kinds of pain medication 9. Different delivery systems 10. Compliance issues

12. Key educative points: Patients Myths and Misconceptions (Pain Action Guide, American Pain Foundation, 2000)  Living with pain is a sign of strength  Pain is pain - whether from a headache or broken leg  Pain has no impact on anyone but me  Pain has nothing to do with recovery

13. Key educative points: Patients Myths and Misconceptions  If I take medication, I may become hooked.  If I take too much medicine, it will stop working.  I can only ask for help when I have severe pain.  If I complain too much, I am not being a good patient.

14. Managing Pain Video: Pre and post viewing Survey Items Q1 Three benefits of pain control48% correct71% correct Q2 Pain scale used for74% correct94% correct Q3 Zero on a pain scale88% correct99% correct Q4 Three things to tell your HCP re:pain62% correct89% correct Q5 Three ways to relieve pain47% correct78% correct Q6 Knowledgeable re: rights(Scale 1-5)2.84.2 Q7 Comfortable communicating pain (Scale 1-5)4.34.7 Q8 How active pursuing pain relief (Scale 1-5)3.94.5 Q9 Resist taking pain meds56% No91% No Q10 Experienced pain94% Yes-- Q11 If pain, tell your HCP97% Yes-- Q12 Relief at desired level76% Yes-- Q13 If no, tell your HCP88% Yes-- Q14 Overall rating of video- 87% Excellent&Very Good

15. 1.Personal beliefs and values 2.Lack of knowledge 3.Lack of resources 4.Incomplete or inaccurate assessment Barriers to Pain Management: Provider

16. Pain Management Assessment Performing a task vs engaging a client 1.What is pain 2.Pain Scale 3.Pain descriptors (W4 Guide) 4.Pain tolerance interpretation 5.Benefits of pain management 6.Importance of pain management 7.Misconceptions/concerns 8.Ongoing assessment/education 9.Pain Bill of Rights

17. Assessing and Communicating Pain Scales The W4 Guide:  Where is the pain?  What makes it worse/better?  What does the pain feel like?  When is the pain worse/better? Assess for pain every visit

18. References American Pain Foundation, www.painfoundation.org, 1-888-615-PAIN American Cancer Society, www.cancercare.org, 1-800-813-HOPE American Chronic Pain Association, www.theacpa.org, 1-916-632-0922 Joint Commission on Accreditation of Healthcare Organizations (JCAHO), www.jcaho.org