Adherence of pain assessment to the German national standard for pain management in 12 nursing homes.
BACKGROUND
Pain is very common among nursing home residents. The assessment of pain is a prerequisite for effective multiprofessional pain management. Within the framework of the German health services research project, 'Action Alliance Pain-Free City Muenster', the authors investigated pain assessment adherence according to the German national Expert Standard for Pain Management in Nursing, which is a general standard applicable to all chronic⁄acute pain-affected persons and highly recommended for practice.


OBJECTIVE
To evaluate the state of pain assessment and to identify need for improvement in 12 nursing homes in a German city.


METHODS
In the present study, the authors used an ex-post-facto design (survey methodology). Available written policies for routine pain assessment in residents ≥65 years of age were reviewed and a standardized online survey completed by 151 of 349 nurses in 12 nursing home facilities was conducted between September 2010 and April 2011.


RESULTS
Most of the included nursing homes provided written policies for pain assessment, and the majority of nurses reported that they assess and regularly reassess pain. However, observational tools for residents with severe cognitive impairment and written reassessment schedules were lacking in many facilities or were inconsistent.


CONCLUSIONS
Essentially, pain assessment appeared to be feasible in the majority of the German nursing homes studied. However, the absence or inconsistency of reassessment schedules indicate that pain management guidelines should include a detailed and explicit reassessment schedule for the heterogenic needs of nursing home residents. For residents with severe cognitive impairment, assessment tools are needed that are simple to use and clearly indicate the presence or absence of pain.
Jürgen
J
Osterbrink
Zsuzsa
Z
Bauer
Barbara
B
Mitterlehner
Irmela
I
Gnass
Patrick
P
Kutschar
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications; D005858:Germany; D006801:Humans; D009735:Nursing Homes; D010146:Pain / Q000150:complications / Q000175:diagnosis*; D059408:Pain Management / Q000592:standards*; D017410:Practice Guidelines as Topic