Documented nursing practices of pain assessment and management when communicating about pain in dementia care.
Yvette I-Pei Tsai, Graeme Browne, Kerry Jill Inder
PMID 35436007WHAT IT FOUND
Pain was frequent in hospitalized people with dementia, but nurses mostly used self-report scales even in moderate or severe dementia, and pain scores were not linked to medication within 60 minutes.
Key findings
01During admission, pain was reported in 66% of patients, and 58% of those with pain had scores of 5 or higher for moderate to severe pain.
02Most nurses used self-report pain tools (93%) rather than observational tools (7%), including in moderate and severe dementia.
03Pain scores were not linked to medication given within 60 minutes; 65 of 315 pain scores were followed by medication in that time.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Retrospective record review depends on what was documented, so missing notes can affect the results. The study included 100 records from 2 hospitals between 1 January 2017 and 31 August 2017, so it may not apply to other settings. MMSE was used to classify dementia severity, but it can be insensitive and some scores were missing. Non-pharmacological pain management was documented in too few records for statistical analysis. The study reviewed records rather than directly observing nurse-patient communication. The study cannot show that pain caused longer stay or that nurses ignored pain scores.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that pain scores should be abandoned. The study found no link between pain scores and medication within 60 minutes, but it reviewed records rather than watching nurses, so missing documentation could explain the gap.