Researchers identify predictors for inpatient pain

September 21, 2012

Researchers from Mount Sinai School of Medicine have identified reliable predictors of pain by surveying patients throughout their hospital stays about the severity of their pain and their levels of satisfaction with how their pain was managed by hospital staff. Using this data, interdisciplinary teams treating patients were able to identify patients at higher risk for pain prior to, or immediately upon, their admission to the hospital, and create and implement intervention plans resulting in patients reporting lower levels of pain and higher levels of satisfaction with their pain management. The study is published online in the American Journal of Medical Quality.

"To our knowledge, this is the first time hospital-wide data on and levels of satisfaction with have been reported. While the factors that predict patients likely to experience higher levels of pain may not be surprising, we were able to show that awareness of and targeted responses to those factors decrease pain and increase ," said David L. Reich, MD, Professor and Chair of Mount Sinai's Department of and lead author of the study. "The important point here is that institutions that use their available data and take an interdisciplinary approach to pain management can be successful in improving the ."

Researchers found patients who identified their pain during their as moderate or severe were more likely to be younger, female, admitted for longer hospital stays, or using psychoactive medications. Level of pain was also found to vary depending on the department of the treating physician.

Patients treated by surgical services reported greater pain severity. Prior to identifying the predictors, patients undergoing lower extremity joint replacement in the Department of Orthopaedics reported an average pain level of 5, on a scale of 0 – 10, on the first day after surgery. After analyzing the predictive data, the interdisciplinary team introduced new protocols that altered the types of oral and intravenous medications given, and allowed use of epidural morphine outside of intensive care settings. The average reported pain level decreased to 3.

"The involvement of our nurses and doctors at the bedside in this study is a strength and demonstrates our commitment to understanding and improving pain management, said Carol Porter, DNP, RN, Chief Nursing Officer and a participating author of the study.

For the initial phases of the study, the researchers evaluated clinical and administrative data stored at Mount Sinai on 38,544 adult inpatients from January 2008 through April 2009, to identify a numeric scale of pain severity associated with patient satisfaction. They then developed a model to predict that metric of pain prior to or immediately upon admission to the hospital.

Using the results of the predictive model, an interdisciplinary pain management team developed and implemented practice-based and evidence-based intervention. The researchers then analyzed the responses to those interventions from January 2009 through March 2011, to determine the effect on pain severity and patient satisfaction.

Overall, reported pain levels decreased by 3.6 percent per quarter in 2010 compared with 2009, and patient satisfaction increased. In five of 11 departments, the decrease in pain severity was statistically significant in 2010 compared with 2009. No department reported that their patients experienced increased pain during that time.

Explore further: Inadequate pain meds in ER for patients with long-bone fractures

Related Stories

Inadequate pain meds in ER for patients with long-bone fractures

May 21, 2012
(HealthDay) -- The majority of patients with long-bone fractures receive inadequate pain medication in the emergency department, and disparities in management exist, according to a study published in the May issue of the ...

Anxiety trait linked to postoperative pain in men following total knee replacement

February 8, 2012
Increased pain following surgery has long been linked to anxiety and "catastrophizing," an extreme response to stress.

Fatigue not a factor in fibromyalgia pain, study says

April 26, 2012
(HealthDay) -- Poor sleep is not a significant predictor of pain intensity and duration in patients with fibromyalgia, a new study says.

Scripted interactions helpful in assessing patient pain

June 5, 2012
(Medical Xpress) -- Given the amount of time they spend with patients, it's nurses more often than physicians who tend to a patient's pain. But few studies have shown how nurses can work with patients to best determine that ...

Recommended for you

To combat teen smoking, health experts recommend R ratings for movies that depict tobacco use

July 21, 2017
Public health experts have an unusual suggestion for reducing teen smoking: Give just about any movie that depicts tobacco use an automatic R rating.

Aging Americans enjoy longer life, better health when avoiding three risky behaviors

July 20, 2017
We've heard it before from our doctors and other health experts: Keep your weight down, don't smoke and cut back on the alcohol if you want to live longer.

Opioids and obesity, not 'despair deaths,' raising mortality rates for white Americans

July 20, 2017
Drug-related deaths among middle-aged white men increased more than 25-fold between 1980 and 2014, with the bulk of that spike occurring since the mid-1990s when addictive prescription opioids became broadly available, according ...

Parents have critical role in preventing teen drinking

July 20, 2017
Fewer teenagers are drinking alcohol but more needs to be done to curb the drinking habits of Australian school students, based on the findings of the latest study by Adelaide researchers.

Fresh fish oil lowers diabetes risk in rat offspring

July 19, 2017
Fresh fish oil given to overweight pregnant rats prevented their offspring from developing a major diabetes risk factor, Auckland researchers have found.

High-dose vitamin D doesn't appear to reduce the winter sniffles for children

July 18, 2017
Giving children high doses of vitamin D doesn't appear to reduce the winter sniffles, a new study has found.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.