•
Conclusions
• Patients admitted with chronic pain are more likely
to experience pain and rate it more severely in
comparison to those patients admitted for surgery
or with cancer or none of these.
• Increased pain management training and
knowledge would help nursing staff.
• Volunteers found the experience insightful and
rewarding.
• Patients were happy to participate and have
someone to talk to.
• Successful demonstration of the effectiveness of
the raid model.
• Useful data, but unable to benchmark against
other organisations.
• Lots of opportunity for improvement
Recommendations
• Education package for staff
• Integrated care model for pain (including
multidisciplinary specialist pain management
support available for inpatients and closer working
with community services)
• Increased capacity within the interventional
oncology service
• Pain information booklets for patients
• Shelford Group to repeat the Pain Raid to obtain
data for benchmarking purposes.
•
•
•
NUTH
Pain Raid Headlines
Patients surveyed
Patients currently in pain
Pain does not vary depending on time of day
Average current pain rating
Average pain rating at its worst
Spoken to a staff member about pain in last 24 hours
Action taken had completely or somewhat relieved pain
Action taken was within first hour of telling someone
(NUTH) Do you have an acute or
patients currently in pain
chronic pain problem?
Currently in pain Patients with
NUTH - Do you have an acute or
chronic pain problem?
cancer
7%
42%
Acute
14%
37%
Patients who
have had
operations
Patients who
have longterm or
chronic pain
Other
condition
24%
33%
Chronic
Neither
25%
18%
No
answer
UCLH 2013
NUTH 2014
381
50%
49%
5.07
6.15
72%
511
43%
54%
5.05
7.40
67%
70%
75%
Worst pain score
Spoke to staff because they had been asked about pain
(UCLH) Classification of conditions of
Not recorded
•
•
•
UCLH
Patient unfit/unsuitable
•
Inpatients aged 18
years and over
Exclusions included
only critical care
patients
Two hours, 50
paired volunteers
clinical/ non-clinical,
one script, 2 sites
Staff on-line survey
Data collated
electronically
92%
87%
(UCLH) Current pain rating
100
90
80
70
60
50
40
30
20
10
0
39%
29%
27%
Mild pain Moderate Severe
(1-3)
pain (4-6) pain (7-10)
Conclusions
• Patients admitted with chronic pain are more likely to
experience pain and rate it more severely in comparison
to those patients admitted with acute pain or with cancer
or none of these.
• Staff seem to under-represent chronic pain and overrepresent acute pain in comparison to patient perception
of their pain.
• Volunteers found the experience very rewarding and
would volunteer again
• Patients were keen to participate.
• Successful demonstration of the effectiveness of the raid
model, and suggest its transferability to other areas of
health care.
• Ability to benchmark data.
Recommendations
• Education package for staff
• Map journey for patients admitted with chronic pain - is
admission the best option if surgery is not required?
• Review when staff survey results are available.
90%
97%
(UCLH) Pain rating at its worst
Percentage (%)
•
•
Inpatients aged 12 years and
over who had at least 1
overnight stay
Exclusions included maternity
patients, psychiatric patients
and day cases
Two hours, 50 non-clinical
volunteers, 4 sites
Main survey- 13 questions
Abby Scale used to assess pain
for patients cognitively impaired
Nursing staff survey
35%
30%
25%
20%
15%
10%
5%
0%
Patient unavailable
•
NUTH 2014
Patient refused
UCLH 2013
100
90
80
70
60
50
40
30
20
10
0
Frances Blackburn, Head of Nursing
Alison Blackburn, Acute Pain Nurse Specialist, RVI
Angela Knight, Acute Pain Nurse Specialist, FRH
NUTH Success Criteria
• To demonstrate how adult inpatients feel their pain is
managed within our Trust
• To discover how our staff feel about their knowledge, skills
& ability to deal with patients who have or are likely to
experience pain
• To positively inform us how to transform patient & staff
experiences where necessary when dealing with pain
management
• To demonstrate the effectiveness of the ‘Raid Model’ and
its transferability to other areas of health care.
Reasons for not completing surveys
Empty bed
UCLH Success Criteria
• Providing depth to data available from national
inpatient surveys about pain management
experience.
• Obtaining snapshot information about inpatient
pain experience across all sites.
• Stratifying data on pain experience and its
management by conditions .
• Understanding how pain management practices
may vary across the Trust, the confidence staff
have in caring for patients in pain, and what can
be done to improve the quality of care staff are
able to provide.
• Informing improvements to patient and staff
experience of pain management.
In May 2013, UCLH designed and carried to repeat the survey, NUTH carried out a ‘Pain Raid’ in April 2014. This poster outlines the approach taken,
findings and recommendations. out the ‘Pain Raid’ to obtain data to better understand the pain management experiences of inpatients within the Trust.
In response a call out to the Shelford Group
Percentage (%)
Lisa Anderton, Programme Lead Patient & Staff Experience
Viki Mitchell, Divisional Clinical Director Theatres &
Anaesthetics
Charlotte Hazelton, Project Manager Patient & Staff
Experience
Pain Raid Survey 2013 - 2014
(NUTH) Current Pain Score
(NUTH) Worst Pain Score
60
Acute
Chronic
Other
50
55%
40
30
16%
11%
17%
20
10
No pain Mild pain Moderate Severe
(0)
(1-3) pain (4-6) (7-10)
Special thanks to all the volunteers and executive boards at UCLH and NUTH who helped bring this project to fruition, and to the steering committees and senior nurses who facilitated the project from its inception through to completion.
0
0
1
2
3
4
5
6
7
8
9 10