54 Improving assessment of pain in palliative care

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Abstract

Background

Evidence has shown it is essential within palliative care that pain assessment is consistent, effective and documented in order to achieve high quality pain control.1

Aim

The aim of this project was to implement a validated pain assessment tool into clinical practice at an independent hospice.

Method

A systematic literature review with databases AHMED, MEDLINE, PsychINFO, CINAHL and EMBASE to identify validated pain assessment tools was conducted. This was followed by a retrospective audit of 40 clinical records, measured against the Hospice UK pain management audit tool as a percentage of compliance.

Results

6 publications (from 500) met the systematic literature review inclusion criteria and identified 11 pain assessment tools. Analysis of the literature concurred with the European Association of Palliative Care recommendations in the use of the multi-dimensional Brief Pain Inventory (BPI) as a pain assessment tool within palliative care. The results of the audit highlighted inconsistencies in documentation of pain assessment across clinical settings and between clinicians. The inpatient unit scored a higher percentage of compliance in the three main audit categories.

Conclusion

The results indicated that pain assessment and management is not documented consistently particularly within the community setting. Evidence from the systematic literature review highlighted that the adoption of a set process in conjunction with the BPI pain assessment tool will ensure essential elements of pain assessment are consistently addressed and documented to improve pain control. The Hospice is in the process of implementing the BPI and pain assessment subsequently will be reaudited.

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