St Anne's Nursing Home, NSW - Pain management - awarded 2009

St Anne's Nursing Home, NSW

In response to survey results regarding pain management that indicated improvement would benefit the residents, a comprehensive program was commenced in 2007. This program involves prevention of pain through exercise programs, activities programs, falls prevention, and the minimisation of pain through the introduction of massage and hot packs, improved monitoring and assessment systems for pain, and improved responsiveness and effectiveness of nursing staff interventions through education and improved buzzer system.

The program includes:

Education on pain management had been provided for nursing staff of all levels. This includes increasing awareness of subtle symptoms of pain, and the importance of dealing with pain, how pain pathways work and simple interventions such as repositioning, through to medication management.

Ongoing educationis planned related to pain management and includes conferences, palliative care programs & sponsorship for University training.

The Abbey pain scalewas introduced for the assessment of residents with dementia, and a modified Abbey scale was introduced for quick assessments of residents having routine analgesia.

Forms for the documentation of narcotic patches were adapted so that they have pictures to allow for better identification of rotation of sites, to ensure effective application of occurs. This was in line with best practice guidelines.

Research into safe hot packs lead to the purchase of Chemically activated hot packs and the development of a relevant policy. Hot packs are now routinely used for residents with significant benefits and their effect is documented on icare.

Case conferencingthat involves the resident’s families was introduced as a routine practice for each resident at least once per year. Where pain was identified as an issue a multidisciplinary approach is utilized so that management options can be explored.

Prevention of painincludes falls prevention, exercises and activities. Our falls prevention program includes regular assessment and monitoring and exercise programs.

Distraction techniquesare utilized to reduce perception of pain. Activity sessions have been introduced on Saturdays.

Physiotherapy interventions include assessment then the development of an individualized program which is implemented by nursing staff and physio staff and includes Tai chi classes.

This program has proven to be effective and continues to be improved through evaluation and researching what else is available. We are currently considering the introduction of “Acupressure” therapy which can be quickly and easily provided by staff. Following a palliative care conference preparation has been commenced for the introduction of end of life pathways.