Title

Evaluation of Musculoskeletal Pain Management Practices in Rural Nursing Homes Compared with Evidence-Based Criteria

Document Type

Article

Peer Reviewed

1

Publication Date

1-1-2009

Journal, Book or Conference Title

Pain Management Nursing

NLM Title Abbreviation

Pain Manag Nurs

PubMed ID

19481044

DOI

10.1016/j.pmn.2008.02.008

Abstract

Chronic pain, mainly associated with musculoskeletal diagnoses, is inadequately and often inappropriately treated in nursing home residents. The purpose of this descriptive study is to identify the musculoskeletal diagnoses associated with pain and to compare pain management of a sample of nursing home residents with the 1998 evidence-based guide-fine proposed by the American Geriatrics Society (AGS). The sample consists of 215 residents from 13 rural Iowa nursing home homes. The residents answered a series of face-to-face questions that addressed the presence/absence of pain and completed the Mini Mental State Examination (MMSE). Data on pain were abstracted from the Minimum Data Set (MDS). Analyses included descriptive statistics, cross tabulations, and one-way analysis of variance. Residents' responses to the face-to-face pain questions yielded higher rates of pain compared with the MDS pain data. Resident records showed that acetaminophen was the most frequently administered analgesic medication (30.9%). Propoxyphene, not an AGS-recommended opioid, was also prescribed for 23 residents (10.7%). Of the 70 residents (32.6%) expressing daily pain, 23 (32.9%) received no scheduled or pro re nata analgesics. There was no significant difference between MMSE scores and number of scheduled analgesics. Additionally, residents' self-reported use of topical agents was not documented in the charts. The findings suggest that the 1998 AGS evidence-based guideline for the management of chronic pain is inconsistently implemented. (C) 2009 by the American Society for Pain Management Nursing

Published Article/Book Citation

The definitive version was published in Pain Management Nursing, 10:2 (2009) pp.58-64. DOI:10.1016/j.pmn.2008.02.008.

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URL

http://ir.uiowa.edu/nursing_pubs/216