Skip to main content

Quality and Safety in Acute Pain Management

  • Chapter
  • First Online:
Pain Management for Clinicians

Abstract

Despite the remarkable amount of research and development looking to advance the treatment options for the human experience of pain, evidence is mounting that pain continues to be poorly managed in health care (reference needed). There is a lack of coordination and clinical integration of evidence-based practice in delivering effective pain management to the bedside by health care professionals, resulting in unnecessary physical, psychological, and emotional negative consequences to patients (Czarnecki ML, Turner HN, Collins PM, Doellman D, Wrona S, Reynolds J. Pain Manag Nurs. 2011;12(2):95–111). Regulatory agencies, such as the Joint Commission, and oversight agencies, such as the World Health Organization, have unanimously declared that appropriate pain management is an essential part of excellence in patient care (Apfelbaum JL, Chen C, Mehta S, Gan T. Anesth Analg. 2003;97(2):234–540). In this chapter, we highlight the challenges in defining what is “high quality” in pain management and call out many of the challenges in safely treating acute pain in the peri-operative hospital setting.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Institute of Medicine (US) Committee to Design a Strategy for Quality Review and Assurance in Medicare. In: Lohr KN, editor. Medicare: a strategy for quality assurance: VOLUME II sources and methods. Washington, DC: National Academies Press (US); 1990. 5, Defining Quality of Care.

    Google Scholar 

  2. Richardson WC, et al. Crossing the quality chasm: a new health system for the 21st century. Available from National Academy Press. 2001.

    Google Scholar 

  3. McDonald KM, Sundaram V, Bravata DM, et al. Closing the quality gap: a critical analysis of quality improvement strategies (Vol. 7: care coordination). Rockville: Agency for Healthcare Research and Quality (US); 2007. Technical Reviews, No. 9.7.

    Google Scholar 

  4. Gordon DB, et al. American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force. Arch Intern Med. 2005 Jul 25;165(14):1574–80.

    PubMed  Google Scholar 

  5. Bendinger T, Plunkett N. Measurement in pain medicine. BJA Educ. 2016;16(9):310–5.

    Google Scholar 

  6. Requirement, Rationale, Reference, A publication of the Jount Commission. Issue 11, August 29, 2017. Available from www.jointcommission.org.

  7. Tighe P, et al. Acute pain medicine in the United States: a status report. Pain Med. 2015;16(9):1806–26.

    PubMed  PubMed Central  Google Scholar 

  8. Gordon DB, et al. Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) for quality improvement of pain management in hospitalized adults: preliminary psychometric evaluation. J Pain. 2010;11(11):1172–86.

    PubMed  Google Scholar 

  9. Delgado DA, et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. J Am Acad Orthop Surg Glob Res Rev. 2018;2(3):e088.

    PubMed  PubMed Central  Google Scholar 

  10. Hawker GA, et al. Measures of adult pain: visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP). Arthritis Care Res (Hoboken). 2011;63(Suppl 11):S240–52.

    Google Scholar 

  11. Haefeli M, Elfering A. Pain assessment. Eur Spine J. 2006;15(Suppl 1):S17–24.

    PubMed  Google Scholar 

  12. Bodian CA, et al. The visual analog scale for pain: clinical significance in postoperative patients. Anesthesiology. 2001;95(6):1356–61.

    CAS  PubMed  Google Scholar 

  13. Bird SB, Dickinson EW. Clinically significant changes in pain along the visual analog scale. Ann Emerg Med. 2001;38(6):639–43.

    CAS  PubMed  Google Scholar 

  14. Tashijan RZ. Minimal clinically important differences (MCID) and patient acceptable symptomatic state (PASS) for visual analog scales (VAS) measuring pain in patients treated for rotator cuff disease. J Shoulder Elb Surg. 2009;18(6):927–32.

    Google Scholar 

  15. Joyce CR, et al. Comparison of fixed interval and visual analogue scales for rating chronic pain. Eur J Clin Pharmacol. 1975;8(6):415–20.

    CAS  PubMed  Google Scholar 

  16. Melzack R. The McGill pain questionnaire: major properties and scoring methods. Pain. 1975;1(3):277–99.

    CAS  Google Scholar 

  17. Papageorgiou AC, Badley EM. The quality of pain in arthritis: the words patients use to describe overall pain and pain in individual joints at rest and on movement. J Rheumatol. 1989;16(1):106–12.

    CAS  PubMed  Google Scholar 

  18. Ngamkham S, et al. The McGill pain questionnaire as a multidimensional measure in people with cancer: an integrative review. Pain Manag Nurs. 2011;13(1):27–51.

    PubMed  PubMed Central  Google Scholar 

  19. Melzack R. The short-form McGill pain questionnaire. Pan. 1987;30(2):191–7.

    CAS  Google Scholar 

  20. Dworkin RH, et al. Development and initial validation of an expanded and revised version of the Short-form McGill Pain Questionnaire (SF-MPQ-2). Pain. 2009;144(1–2):35–42.

    PubMed  Google Scholar 

  21. Dworkin RH, et al. Validation of the short-form McGill pain questionnaire-2 (SF-MPQ-2) in acute low back pain. J Pain. 2015;16(4):357–66.

    PubMed  Google Scholar 

  22. Herr KA, Garand L. Assessment and measurement of pain in older adults. Clin Geriatr Med. 2001;17(3):457–78.vi.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Herr KA, et al. Evaluation of the faces pain scale for use with the elderly. Clin J Pain. 1998;14(1):29–38.

    CAS  PubMed  Google Scholar 

  24. Kim EJ, Buschmann MT. Reliability and validity of the faces pain scale with older adults. Int J Nurs Stud. 2006;43(4):447–56. Epub 2006 Feb 28.

    PubMed  Google Scholar 

  25. Pathak A, et al. The utility and validity of pain intensity rating scales for use in developing countries. Pain Rep. 2018;3(5):e672.

    PubMed  PubMed Central  Google Scholar 

  26. Jensen MP et al. The utility and construct validity of four measures of pain intensity: results from a university-based study in Spain. Pain Med. 2019.

    Google Scholar 

  27. Max MB. Quality improvement guidelines for the treatment of acute pain and cancer pain. JAMA. 1995;274(23):1874–80.

    Google Scholar 

  28. Gordon DB. A 10-year review of quality improvement monitoring in pain management: recommendations for standardized outcome measures. Pain Manag Nurs. 2002;3(4):116–30.

    PubMed  Google Scholar 

  29. Schultz H, et al. Psychometric evaluation of the Danish version of a modified revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-D) for patients hospitalized with acute abdominal pain. Scand J Pain. 2019;19(1):117–30.

    PubMed  Google Scholar 

  30. Reddy A, et al. Patterns of storage, use, and disposal of opioids among cancer outpatients. Oncologist. 2014;19(7):780–5.

    PubMed  PubMed Central  Google Scholar 

  31. FDA. FDA NEWS RELEASE – FDA launches public education campaign to encourage safe removal of unused opioid pain medicines from homes. 25 April 2019. Available from www.fda.gov.

  32. Bates C, et al. Overprescription of postoperative narcotics: a look at postoperative pain medication delivery, consumption and disposal in urological practice. J Urol. 2011;185(2):551–5.

    PubMed  Google Scholar 

  33. de la Cruz M, et al. The impact of an educational program on patient practices for safe use, storage, and disposal of opioids at a Comprehensive Cancer Center. Oncologist. 2017;22(1):115–21.

    PubMed  Google Scholar 

  34. DEA Headquarters. Drug Enforcement Administration Collects Record Number Of Unused Pills As Part Of Its 14th Prescription Drug Take Back Day. 7 Nov 2017. Available from www.dea/gov.

  35. Buffington DE. Understanding factors that contribute to the disposal of unused opioid medication. J Pain Res. 2019;12:725–32.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Guttman, O., Shilling, M., Murali, A., Mendelson, A.M. (2020). Quality and Safety in Acute Pain Management. In: Noe, C. (eds) Pain Management for Clinicians. Springer, Cham. https://doi.org/10.1007/978-3-030-39982-5_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-39982-5_30

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-39981-8

  • Online ISBN: 978-3-030-39982-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics