Cancer pain management and the JCAHO's pain standards: an institutional challenge.
Unrelieved pain is a major medical problem. In response to this problem, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) launched new standards for pain management in 1999. A review was conducted in five hospitals of 117 charts of 80 inpatients and 37 outpatients with cancer who had pain documented in their medical records to determine whether application of these JCAHO standards was documented. Pain assessment and management were not documented for most patients. Pain intensity was noted for 57% of outpatients and 53% of inpatients. When pain was documented, treatment was noted in 86% of outpatients' charts and 89% of inpatients' charts. Of those patients with documented pain, reassessment after treatment was reported in 34% of the outpatient charts and 44% of the inpatient charts. Work to properly manage cancer pain needs to continue, and the JCAHO standards provide a mechanism to evaluate practice documentation in order to improve care.
Cohen
Marlene Zichi
MZ
School of Nursing, The University of Texas-Houston Health Science Center, Houston, TX 77030, USA.
Easley
Mary K
MK
Ellis
Coni
C
Hughes
Beverly
B
Ownby
Kristin
K
Rashad
Beverly Green
BG
Rude
Mari
M
Taft
Ellen
E
Westbrooks
Joycelyn Bailey
JB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006761:Hospitals / Q000592:standards*; D006801:Humans; D007591:Joint Commission on Accreditation of Healthcare Organizations; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis*; D059408:Pain Management; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D012189:Retrospective Studies; D014481:United States