Friday, July 14, 2006

Pain as the 5th Vital Sign Toolkit

This Pain as the 5th Vital Sign Toolkit has been prepared as a resource toolkit for use by healthcare professionals. It is organized into the following sections:

Section 1: Introduction. This section presents the objectives of the VHA National Pain Management Strategy and a synopsis of the major sections of this toolkit.

Section 2: An Overview of the VHA National Pain Management Strategy. This section highlights the key components of the strategy and provides recommendations for implementation at individual VHA facilities (or in individual healthcare facilities if it is being used by non-VHA systems).

Section 3: Barriers to Pain Screening and Assessment. This section reviews many of the common barriers to reliable pain screening and assessment, including barriers attributable to healthcare professionals, patients, and the healthcare system. Appreciation of the factors is critical to the development of an effective program for pain management.

Section 4: The Pain Screening Process. This section includes information about the Numeric Rating Scale (NRS) for pain screening, a description of the tool, tips for using it reliably; guidelines for frequency of screening across diverse clinical settings; and suggestions for using the tool within the context of patient/family education on pain and pain management. This section also contains information on methods for documenting pain scores in the patient record.

Section 5: Conducting a Comprehensive Pain Assessment. This section emphasizes the role of pain screening as an initial step in the comprehensive assessment of pain. The section discusses pain as a complex, perceptual phenomenon and provides a rationale for more comprehensive assessment. Key components and commonly employed methods of pain assessment are also described, followed by a description of common barriers to reliable pain assessment.

Section 6: Educational and Resource Information. This section provides information to assist individuals and facilities in the successful implementation of the Pain as the 5th Vital Sign initiative.

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