Quality & Safety
Effectiveness: Pain Management
Why is this measure important?
Pain is a part of life. It alerts us when something is wrong in our body, such as an injury or an infection. However, once we are aware of the problem and are receiving medical care for it, untreated pain can interfere with healing. For example, untreated pain after surgery can prevent a child from coughing, deep breathing, walking and sleeping – all things that are necessary for healing and recovery.
Fortunately, there are many medications and actions that can help to control pain. It is important to understand that all medications, including pain medications, have side effects. An important part of nursing care is to assess pain, administer pain medications, and monitor the patient’s response to the pain medication, including possible side effects. This measure tells us how well we do in managing the pain that our patients experience.
How do we track this measure?
We track how effective our pain management program is by measuring how often our nurses do regular pain assessments, administer pain medication when necessary, and then reassess the situation to make sure the pain medication is working properly. These three steps are known as the pain assessment/intervention/reassessment cycle or AIR cycle.
Four times a year, we look at how often registered nurses on all of our inpatient units follow these steps for patients who have been on the unit for at least 24 hours. Our target is to have 100% of these steps completed for each patient during a 24-hour period.
How do we compare to other hospitals?
We submit data quarterly to a national database that allows us to compare our performance with the performance of similar children’s hospitals across the country.
As of 2011, the three AIR steps were completed 100% of the time in our neonatal unit, critical care unit, medical unit and surgical unit.
What are we doing to improve?
We have a pain management group that works closely with staff on pain management education and documentation. We have also brought together a group of nurses and doctors, including members of our Pain Treatment Service, to come up with a way of measuring the effectiveness of pain management across a broader population of our patients.