Unit 1: Current Pain
Management Practice
Participants learn both common and
formal definitions for pain, and the frequency and common causes of
pain among older adults. Learners will also explore the deleterious
effects of unrelieved pain in older persons, and a number of clinician
barriers to effective pain management.
Unit Objectives
- Define pain
- Recognize potential clinician
barriers to optimal pain management
- Describe your teams current pain
management practices
Assignment: Complete
a baseline chart review of 10 patient records, using a standardized
tool. Results are entered online, providing immediate feedback of
results for six measures related to pain management.
Unit 2: Pain Screening and Assessment
of Intensity
Review patient-related barriers to
effective pain management. Screen all patients for pain, using
the "Ask, Listen and Observe" technique. Tools to assess pain intensity
are provided including those suitable for patients with dementia.
Re-address pain at each home visit ("Pain as the 5th Vital Sign").
Unit Objectives
- Recognize why patients don't always
report their pain
- Explain how to improve pain
screening using the "Ask, Listen, and Observe" technique
- Describe the use of pain intensity
scales
- Explain how to assess patients who
can not communicate their pain
- Understand the importance of
re-addressing pain at each homecare visit
Assignment: Test a change to
introduce pain screening for all older adults, and the use of pain
intensity scales
Unit 3: Optimizing Pain
Management
Use the World Health Organization (WHO) Pain Ladder as a strategy for
pharmacologic pain management. Describe the best uses for, and the
specific risks to older persons of certain non-opioids. Several
categories of adjuvant medications are included. Non-pharmacologic pain
relief modalities conclude the unit.
Unit Objectives
Describe the WHO pain ladder
Identify the key principles of
successful pharmacologic pain management
Learn how to optimize pain management
using pharmacologic resources
Learn how to optimize pain management
using non-pharmacologic resources
Assignment: Complete a pain
management competency test
Unit 4: Pain Assessment and
Care Plan
Identify the subset of patients with
pain who should have a comprehensive pain assessment. Review the core
components of a pain management care plan including how to determine
the patient's pain goal. Use the
Situation-Background-Assessment-Recommendation (SBAR) technique to
communicate with physicians about pain management issues.
Unit Objectives
- Perform a structured assessment
for patients with pain
- Identify the core components of a
pain management care plan
- Define the SBAR communication
technique for communicating pain issues with the patients MD
Assignment: Test a change to
implement the WILDA pain assessment technique
Unit 5: Measuring
Improvement/Holding Gains
Conduct a repeat chart review to
assess progress toward pain management improvement aims, and develop
plans for holding gains post-CHAMP
Unit Objectives
- Re-measure your clinical team's
pain management performance
- Develop a plan to continue making
improvements
Assignment: Complete a chart
review for ten older adult patients, using the same process as in unit
1 and develop a written plan for post-CHAMP activities to sustain and
build on gains.
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