Some Improvements Seen in Hip Fracture Pain Practices

Numeric rating scale assessment has increased; but opioid management has remained static
By Rick Ansorge
HealthDay Reporter

THURSDAY, July 23 (HealthDay News) -- In older adults with hip fractures, pain assessment and management practices in emergency departments have improved since new standards were issued by the Joint Commission on Accreditation of Healthcare Organizations, but the level of care still does not consistently meet best practice guidelines, according to a study published in the July Journal of Emergency Nursing.

Keela Herr, Ph.D., of the University of Iowa in Iowa City, and colleagues abstracted medical records on 1,454 patients who were admitted through the emergency department at 12 acute care hospitals during 2000, 2001, and 2002.

Between 2000 and 2002, the researchers observed that the rate at which pain was assessed with a numeric rating scale had increased from 16.5 to 54.4 percent. However, they were concerned that the number of patients not receiving any analgesic had only decreased from 32 to 24 percent, and that the number of patients receiving the preferred treatment for moderate-to-severe pain -- opioids -- remained below 60 percent during all three time periods.

"Ideas for future research include how to improve the use of evidence-based practices for acute pain management of older adults in the emergency department setting; how to best educate the patient regarding importance of treating acute pain and the use of pain assessment scales in the emergency department; improving behavioral assessment approaches in the emergency department; identifying barriers to use of evidence-based practices; and improving collaboration with physicians to provide optimal acute pain assessment and management in this setting of care," the authors conclude.

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