The Implementation of a Functional Pain Scale in a Rural Internal Medicine Clinic with Significant Opioid Use
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Authors
Creevan, Kelsie
Issue Date
2023-05-11
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Manuscript
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Keywords
Functional Pain , Pain Scale , Functional Mobilit
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Abstract
Purpose: The purpose of this quality improvement project is to implement the use of a functional pain scale and provide education regarding the impact of chronic pain on an individual’s activities of daily living. The aim of the quality improvement is to improve the process or delivery of standard of care.
Background: The Joint Commission implemented pain as the 5th vital sign in 2001, opening the door for increased opioid prescribing to meet the goal. Over a quarter of a billion opioid prescriptions were written in 2012 equaling the adult population of the U.S. at that time. Increased prescribing of opioids has resulted in addictions accounting for at least 600,000 deaths. In 2018 the Joint Commission and American Academy of Family Physicians recommended focusing pain management based on patient functional pain level.
Sample/Setting: A convenience sample method was used at an internal medicine clinic in Beatrice, NE with the inclusion criteria of those 18 years and older and a pain >0 on the numerical pain scale (NPS).
Methods: Participating adults will complete the functional pain scale during the rooming process. The provider will use the results to determine if current interventions are effective or if additional interventions are necessary including pharmacological and non-pharmacological management.
Results: The project ran for 8 weeks; reports indicate that 47 out of 67 cases of numerical pain score not matching the functional pain score. Additionally, 22 of the participants were currently on opioids.
Conclusion: The numeric pain scale is subject and does not assess how a patient’s functional mobility is influenced by their pain. Addressing the patient’s functional pain not only addresses the recommendations of the Joint Commission and American Academy of Family, but also assists in creating patient goals.
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University