Resources

Patient Rights and Organization Ethics

Note:  Pain related text in the standards and intents is underlined. Standard RL1.2 - Patients are involved in all aspects of their care.

Intent of RI.1.2 - Hospitals promote patient and family involvement in all aspects of their care through implementation of policies and procedures that are compatible with the hospital’s mission and resources, have diverse input, and guarantee communication across the organization. Patients are involved in at least the following aspects of their care:

Among Others: Making care decisions, including managing pain effectively.

Standard R1.L2.7 - The hospital addresses care at the end of life.

Intent of 111.1.2.7 - Dying patients have unique needs for respectful, responsive care. All hospital staff are sensitized to the needs of patients at the end of life. Concern for the patients comfort and dignity should guide all aspects of care during the fmal stages of life.

Among Others: managing pain aggressively and effectively;

Effective pain management is appropriate for all patients, not just for dying patients (see standards RI.1.2.8 and PE.1.4). Standard RI.L2.8 - Patients have the right to appropriate assessment and management of pain.

Intent of RI.L2.8 - Pain can be a common part of the patient experience; unrelieved pain has adverse physical and psychological effects. The patient’s right to pain management is respected and supported. The organization plans, supports. and coordinates activities and resources to assure the pain of all individuals is recognized and addressed appropriately. This includes:

·        initial assessment and regular reassessment of pain;

·        education of relevant providers in pain assessment and management;

·        education of patients, and families when appropriate, regarding their roles in managing pain as well as the potential limitations and side effects of pain treatments; and

·        after taking into account personal, cultural, spiritual, and/or ethnic beliefs, communicating to patients and families that pain man agement is an important part of care.

 Standard PE.1.4 - Pain is assessed in all patients.

Intent of PE.1.4 - In the initial assessment, the organization identifies patients with pain. When pain is identified, the patient can be treated within the organization or referred for treatment. The scope of treatment is based on the care setting and services provided. A more comprehensive assessment is performed when warranted by the patients condition. This assessment and a measure of pain intensity and quality (eg, pain character, frequency, location, duration), appropriate to the patient’s age, are recorded in a way that facilitates regular reassessment and follow up according to criteria developed by the organization,

Standard TX.3.3 - Policies and procedures support safe medication prescription or ordering.

Intent of TX.3.3 - Procedures supporting safe medication prescription or ordering address

Among Others: appropriate use of patient-controlled analgesia (PCA), spinalepidural, or intravenous administration of medications and other pain management techniques in the care of patients with pain;

Standard TX.5.4 - The patient is monitored during the post-procedure period.

Intent of TX.5.4 - The patient is monitored continuously throughout the post-procedure period. The following items are monitored:

Among Others: Pain intensity and quality (for example, pain character, frequency, location, duration) and responses to treatments.

Standard PF.3.4 - Patients are educated about pain and managing pain as part of treatment, as appropriate.

Intent of PF.3.4 - When appropriate, patients and families are Instructed about understanding pain, the risk for pain, the importance of effective pain management, the pain assessment process, and methods for pain management, when identified as part of treatment.

CONTINUUM OF CARE

Note; Pain related text in the standards and intents is underlined.

Standard CC.6.1 - The discharge process provides for continuing care based on the patients assessed needs at the time of discharge.

Intent of CC.6.1 - Discharge planning focuses on meeting patients’ health care needs after discharge. Discharge planning identifies patients continuing physical, emotional, symptom management (for example, pain, nausea, or dyspnea), housekeeping, transportation, social, and other needs, and arranges for services to meet them.