{"id":65087,"date":"2019-05-22T00:00:00","date_gmt":"2019-05-22T05:00:00","guid":{"rendered":"https:\/\/www.unmc.edu\/newsroom\/2019\/05\/22\/talking-to-patients-about-their-pain\/"},"modified":"2022-09-02T17:32:28","modified_gmt":"2022-09-02T22:32:28","slug":"talking-to-patients-about-their-pain","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/newsroom\/2019\/05\/22\/talking-to-patients-about-their-pain\/","title":{"rendered":"Talking to patients about their pain"},"content":{"rendered":"<div class=\"panel body-content\"><div class=\"panel__container\"><p>It can be one of the biggest challenges in caring for hospitalized patients &#8212; managing their pain. <\/p>\n<p>In 2017, in response to the opioid crisis, Nebraska Medicine&#8217;s <a href=\"https:\/\/now.nebraskamed.com\/news\/can-we-manage-pain-without-fueling-addiction\/?highlight=pain%20management\">pain management work group<\/a> revised pain medication order sets to help providers prescribe pain medicine in a responsible way. The team also partnered with the Pain Resource Network (PRN) to educate frontline staff on alternatives to pain medication, including heat\/cold, music and guided imagery. <\/p>\n<p>&#8220;We saw that when we prescribe more appropriate regimens for pain, we can simultaneously decrease our use of opioids and improve our patients&#8217; pain control,&#8221; said <a href=\"https:\/\/www.unmc.edu\/intmed\/divisions\/gim\/faculty\/sarahrichards.html\">Sarah Richards, M.D.<\/a>, assistant professor of internal medicine at UNMC and medical director of patient experience at Nebraska Medicine.<\/p>\n<p>The data shows the new orders and alternative techniques are working well, with a decline in the amount of medications and the number of interventions and safety events, while improving patients&#8217; pain control.<\/p>\n<p>From July 1, 2016 to March 31, 2019, the number of opioid medication orders per 1,000 patient days decreased overall by 35%.<\/p>\n<p>Today, another important focus has come into view &#8212; how often we talk to our patients about their pain.<\/p>\n<p>&#8220;When uncontrolled pain is ignored by even one provider, it can have a negative impact on the patient&#8217;s entire hospital experience,&#8221; said <a href=\"https:\/\/www.unmc.edu\/intmed\/divisions\/gim\/faculty\/jasonshiffermiller.html\">Jason Shiffermiller, M.D.<\/a>, assistant professor of internal medicine. <\/p>\n<p>In 2018, questions regarding pain changed on the inpatient surveys patients receive after they are discharged. <\/p>\n<p>These two questions:<\/p>\n<ul>\n<li>During this hospital stay, how often was your pain well controlled?\n<li>During this hospital stay, how often did the hospital staff do everything they could to help you with your pain?<\/ul>\n<p>Changed to the following questions in 2018:<\/p>\n<ul>\n<li>During this hospital stay, how often did hospital staff talk with you about how much pain you had?\n<li>During this hospital stay, how often did the hospital staff talk with you about how to treat your pain?<\/ul>\n<p>(Answer choices are never, sometimes, usually and always).<\/p>\n<p>&#8220;What is the best way to communicate to our patients about their pain?&#8221; Dr. Richards asked. &#8220;Some patients won&#8217;t admit they are in pain, some are afraid of becoming addicted to medication and some fear the perception of needing help with their pain. It&#8217;s important for all care team members to be mindful of this.&#8221;<\/p>\n<p> &#8220;The PRN members have been champions on all the inpatient units to educate those at the bedside and demonstrate techniques for pain reassessment,&#8221; said Peggy Mazzeo, care transitions nurse and PRN co-chair.<\/p>\n<p>&#8220;Those reassessments are important and directly correlate to a patient&#8217;s perception that their health care team cares about their pain,&#8221; Dr. Richards said. <\/p>\n<p>The data demonstrates this work is having a positive impact on patients.<br \/>\n&#8220;When the team started this work in 2016, our pain scores were in the 10th to 20th percentile when compared to like-size hospitals,&#8221; Dr. Richards said. &#8220;Since then, our pain scores have climbed significantly, to the 83rd percentile thus far in fiscal year 2019.&#8221; <\/p>\n<p>Now the challenge becomes how to sustain the momentum.<\/p>\n<p>&#8220;We created a tool that physicians can use to educate their students and residents on how to talk to their patients about their pain,&#8221; Dr. Shiffermiller said.  <\/p>\n<p>Providers can find the information on Apollo by clicking <a href=\"https:\/\/www.nebraskamed.com\/for-providers\/apollo-login\">this link<\/a>. Search for &#8220;Provider Pain Management.&#8221; If the window does not open, change your settings to allow for pop-up windows. There is a separate training for nurses called &#8220;Nurses Pain Management.&#8221;<\/p>\n<p><a href=\"https:\/\/vimeo.com\/337325278\">Learn more in this brief video featuring Sarah Richards, M.D., and Jason Shiffermiller, M.D.<\/a><\/p>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>A new tool on Apollo is designed to help providers have that conversation.<\/p>\n","protected":false},"author":27,"featured_media":65088,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-65087","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","department-unmc-today-todays-headlines","author_override-nebraska-medicine"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Talking to patients about their 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