Pain Screening
::
::
::
::
::
::
::
::
::
::
::
|
|
A Minimum Data Set Prevalence of Pain Quality Indicator: Is it Accurate and Does it Reflect Differences in Care Processes?
Mary P. Cadogan, John F. Schnelle, Noriko Yamamoto-Mitani, Georgina Cabrera, and Sandra F. Simmons, 2004, in Journal of Gerontology: Medical Sciences; 59:M281-M285.
- Federal regulations require nursing homes to complete resident assessments periodically using the Minimum Data Set (MDS) assessment protocol. Results are used to generate quality indicators (QI) in a number of clinical areas for each facility, which consumers can then use to compare nursing homes. But the use of QIs as a measure of quality of care is controversial due in part to concerns about the accuracy of staff-generated MDS data.
This study, conducted in 16 nursing homes, collected independent data that showed that the MDS quality indicator for "prevalence of pain" does indeed accurately discriminate between facilities. Interpretation of the pain indicator requires caution, however. Rather than reflecting poor quality, a high prevalence of pain according to the MDS was associated with better pain assessment and treatment care processes. This study reports results from eight nursing homes that scored in the upper 75th percentile on the prevalence of pain QI and eight nursing homes that scored in the lower 25th percentile for the same QI. Research staff collected data through interviews with 255 residents and medical record reviews.
In high prevalence homes, 47% of the participating residents had pain documented on their most recent MDS and the same percentage reported symptoms of chronic pain during interviews with research staff. By contrast, in low prevalence homes, 9% of the participating residents had pain documented on their most recent MDS, but 27% reported chronic pain symptoms in interviews.
On every measure of pain-related care quality independently evaluated in this study (see our pain care quality indicators), nursing homes with a high reported prevalence of pain on the MDS performed better than nursing homes with low MDS pain prevalence. One explanation, according to the authors, is that a higher prevalence of pain among residents sensitizes nursing home staff to the need for better overall care for pain.
(prev | next)
|
|
|
