Using this tool, the pain unit staff is able to localise, follow up and assess the source of the pain. Based on the assessment results, they may decide to revise the medication their patient is on.
The new tool has been included in a platform, where the patient's clinical history is stored together with lab/medical imaging tests results and nurse logs. On a daily basis and in shifts, the hospital staff checks vital signs (temperature, blood pressure, heart rate, respiratory rate).
With this new development, there is a new, fifth constant that the staff can monitor on a regular, homogenous and reproducible basis; the Visual Analogical Scale (VAS) level, a method for measuring the intensity of pain in patients. The scale consists of a horizontal line with two marks at its extremities, i.e. the lowest and the highest levels of pain. For certain patients it is necessary to complement it with a numerical scale from 1 to 10. The hospital staff records such data as well as their characteristics, localisation, duration and the situations that relieve or worsen it.
Based on all this information, the new system generates three lists: (1) newly hospitalised patients and their VAS level; (2) evolution of patients being treated at the pain management unit of the hospital, and (3) patients being treated with special analgesics such as morphine patient controlled analgesia (PCA) pumps (electronic or mechanical), epidurals, catheters, etc.
Daily, experienced nurses who are well trained in pain management check these lists and visit hospitalised patients whose VAS level is 3 or more. They perform an exhaustive and structured assessment of the intensity and characteristics of the pain as well as of the current treatment, and if they deem it necessary, they will propose, consult on and request a change of analgesic treatment.
For each hospitalisation event, the new tool allows creating a folder where all records pertaining to one's pain are gathered. It also stores information of the past four days, thus allowing healthcare professionals to view a brief graphical snapshot of how the pain has evolved. This information is then compared with constants on the occasion of the daily examination, ensuring meticulous assessments of the analgesic treatment and their possible adjustment, if applicable, by means of the pharmaceutical application, which is connected with the pain management tool.
The result of this is a lively platform which is updated regularly and that enables the exchange of feedback between professionals while facilitating patient pain management, in a way to alleviate pain as early as possible.
The pain management application was launched in 2009 under a first pilot phase in a specialist surgery unit of the hospital. Since a nurse joined the pain unit in June 2011, 1 400 patients with acute pain have been seen there. This number has been increasing gradually since the tool has been extended to all hospitalisation units of the hospital. The number of concerned patients tripled between 2011 and 2012, and the daily number of such patients is now between 25 and 30.