Abstract

Pain control in hospital has long been documented as ineffective and problematic. A multi-professional group of clinicians formed to consider how they might continue to improve pain management at a district general hospital. Following a pain audit, in general wards, it became apparent that pain assessment tools were not being used. The group devised a draft pilot assessment tool and care plan which was piloted over a 2-week period on a rehabilitation ward for elderly people. A review of these documents revealed that pain assessment using the body map ascertained considerable detail about the pain location, and the pain ruler elicited pain intensity and associated descriptors. None of the documented goals for pain were measurable, and interventions focused on analgesia and actions to relieve the physical cause of the pain. No psychosocial interventions were mentioned. All care plans were evaluated at least once but 44% of evaluations did not refer to the pain. On this ward, these outcomes suggest the pain assessment tool has the potential to improve communication of pain between the patient and the nurse but there is an urgent need for education to enable this information to be used effectively and develop pain management strategies which reflect the multidimensional nature of pain