title: Is pain assessment feasible as a performance indicator for Dutch nursing homes? A cross-sectional approach.
abstract: Quality of care gains transparency with the help of performance indicators. For Dutch nursing homes, the current set of performance indicators does not include pain. To determine the feasibility of pain assessment as performance indicator, information about pain prevalence and analgesic prescription in one nursing home was collected. Within the time span of 3 days, pain intensity was measured in 91% of the residents (201 out of 221), either with a numeric rating scale, a verbal rating scale, or the Rotterdam Elderly Pain Observation Scale (REPOS). Numerical rating was used for 72%, verbal rating for 3%, and REPOS observation for 25% of the residents. Pain was substantial in 65 residents (32%), who received the following analgesic prescription: World Health Organization (WHO) step 1, 45%; WHO step 3, 12%; and neuroactive agents, 5%. Thirty-eight percent of these residents were in pain and received no analgesics. Residents with substantial pain significantly more often received analgesics (p = .007). Results suggest that pain assessment is feasible in a nursing home and would stimulate staff attention to pain. Further investigation is necessary to find out if a pain algorithm is feasible and will lead to improved pain treatment.
authors: Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands. a.boerlage@erasmusmc.nl
authors: Anneke A
authors: AA
authors: Boerlage
authors: Anniek D
authors: AD
authors: Masman
authors: Jacobus
authors: J
authors: Hagoort
authors: Dick
authors: D
authors: Tibboel
authors: Frans P M
authors: FP
authors: Baar
authors: Monique
authors: M
authors: van Dijk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D005851:Geriatric Nursing / Q000592:standards*; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes / Q000592:standards* / Q000706:statistics & numerical data; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000451:nursing; D059408:Pain Management / Q000379:methods / Q000451:nursing / Q000592:standards*; D010147:Pain Measurement / Q000379:methods / Q000451:nursing* / Q000592:standards; D015995:Prevalence; D011785:Quality Assurance, Health Care / Q000379:methods*; D015203:Reproducibility of Results