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Pain as the 5




Improving Pain Management

Omar Perez
Stacey Lacsina
Daryl Apostol
Brianne Chinen
Izumi Suzuki

Pain as the 5th vital sign, was a phrase introduced

by the American Pain Society. Its goal was to
promote an increased awareness of pain treatment
amongst healthcare professionals.
Vital Signs are taken seriously. If pain were
assessed with the same zeal as other vital signs
are, it would have a much better chance of being
treated properly. We need to train doctors and
nurses to treat pain as a vital sign. Quality care
means that pain is measured and treated.
James Campbell, MD
Presidential Address
American Pain Society
November 11, 1996

Importance of Pain Control

Inadequately managed pain can lead to:
Negative PHYSICAL outcomes for
patients and their families
Negative PSYCHOLOGICAL outcomes
for patients and their families
Poor hospital reputation
Poor patient satisfaction

National Indicators
After a surgical procedure, it is common for
patients to have pain. About 80% of patients
experience pain post-operatively and 11-20%
experiencing severe pain.
The incidence of postoperative pain has
remained the same over the past decade, even
though analgesics are readily available and the
national guidelines to manage pain are in place.

Joint Commission releases standards for pain
Quality Improvement Programs

American Pain Society

1992 Acute Pain Clinical Practice Guidelines
Pain Management of Geriatric Nursing Protocols for Best
ASPAN Pain and Comfort Clinical Guideline

Current Issues Regarding

Pain Management
Inadequate pain assessment,
intervention, and follow up on pain
Lack of education of nurses
Lack of education of patient and
family members/caregivers
Poor time management skills

Key Players Involved

Healthcare team
Patients and
their family

QI Tools for Baseline

Numeric pain scale
Charting software specific to pain
management and assessment
Patient surveys/questionnaires
Follow up questionnaires or phone
interviews after discharge
Flow chart

Improved quality of patient and staff
education regarding pain
Nursing Process and time
Set definite hospital protocols
regarding pain management
Pain management committee
discuss quality, meets quarterly
Staff incentives


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McNamara, M., Harmon, D., & Saunders, J. (2012). Effect of education on knowled
skills and
attitudes around pain. British Journal of Nursing, 12(26), 958-964.
Retrieved February 17, 2015

Nworah, U. (2012). From Documentation to the Problem: Controlling Postoperative

Nursing Forum, 47(2), 91-99. Retrieved February 18, 2015, from Wiley
Online Library.

Pain as the 5th Vital Sign Toolkit. (2002, October 1). Retrieved February 19, 2015,

Wells, N., Pasero, C., & McCaffery, M. (2008, April 1). Improving the Quality of Car
Pain Assessment and Management. Retrieved February 23, 2015, from