Current State of Pain Care for Hospitalized Patients at End of Life
Current State of Pain Care for Hospitalized Patients at End of Life
Yao, Y.,Keenan, G.,Al-Masalha, F.,Lopez, K.,Khokar, A.,Johnson, A.,Ansari, R.,Wilkie, D.
- Caption: Actual final Nursing Outcomes Classification (NOC) outcome ratings for end-of-life patients with pain diagnoses.
We report findings on the current state of pain care in hospitals for end-of-life (EOL) patients using longitudinal data from eight diverse medical-surgical units located in 4 different Midwestern hospitals over 24 months. We identified 1,425 EOL care episodes, 596 (41.3%) of which had a pain diagnosis. The percentage of EOL patients with pain varied significantly across units (p<.001), and was even lower (27.7%) for those with “acute confusion.” Additionally, 30% of EOL patients had severe or significant pain at death or discharge to hospice and only 42.7% actually met the expected pain related outcome ratings. Pain often improved within 48 hours of admission (p<.005), the improvement, however, stagnated following this initial time period (p=.92). A sizable gap between pain science and clinical practice continues.
Citation: Yao, Y., Keenan, G., Al-Masalha, F., Lopez, K., Khokar, A., Johnson, A., Ansari, R., Wilkie, D., Current State of Pain Care for Hospitalized Patients at End of Life, The American Journal of Hospice & Palliative Care, vol 30, no 2, pp. 128–136, 2012-05-01. https://dx.doi.org/10.1177%2F1049909112444458