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Article
Improving the process of pain care in nursing homes: A literature synthesis
Journal of the American Geriatrics Society
  • K. L. Swafford
  • L. L. Miller
  • P. F. Tsai
  • Keela A. Herr
  • M. Ersek
Document Type
Article
Peer Reviewed
1
Publication Date
1-1-2009
NLM Title Abbreviation
J Am Geriatr Soc
PubMed ID
19507298
Abstract

Regulatory agencies, researchers, and clinicians have identified improving pain assessment and management in nursing homes as a high priority, but there is no consensus regarding the best strategies to change pain management practices in nursing homes. The goal of this article is to present a synthesis of published literature of process-level pain management improvement projects in nursing homes and identify and describe the role and necessary skills of various clinicians and nursing leaders in successful interventions. This literature synthesis is limited to research in nursing homes. Reports of research or reports of evaluation of quality improvement programs and descriptions of process interventions that targeted pain assessment and management were reviewed. Studies that focused primarily on the efficacy of pain treatment (e.g., analgesic trials or nonpharmacological therapies) were excluded. Of the original 472 articles, 53 were kept for a full text review. Of these, 10 were included in the final synthesis. Findings from this synthesis suggest that pain management practices may improve with the adoption of systematic implementation models, clinical decision-making algorithms, an interdisciplinary approach, continuous evaluation of outcomes, and use of on-site resource consultants. Clinician leaders in nursing homes require adept pain assessment and management skills and working knowledge of organizational change practices, including quality improvement processes, team building, collaborative decision-making, and assessing and solving system-level problems.

Published Article/Book Citation
Journal of the American Geriatrics Society, 57:6 (2009) pp.1080-1087.
Disciplines
Citation Information
K. L. Swafford, L. L. Miller, P. F. Tsai, Keela A. Herr, et al.. "Improving the process of pain care in nursing homes: A literature synthesis" Journal of the American Geriatrics Society Vol. 57 Iss. 6 (2009) p. 1080 - 1087
Available at: http://works.bepress.com/keela_herr/70/