The Common Sense Guide to Improving Palliative Care > Preventing, Assessing, and Treating Pain > 4.8 Common Barriers to Good Pain Management

Sick To Death book cover This extract from the online edition of The Common Sense Guide to Improving Palliative Care is used with permission.

Common Barriers to Good Pain Management

All improvement efforts encounter barriers. Anticipating and preparing for them will allow your team to overcome problems while staying focused on your aim. Although the Joint Commission on Accreditation of Healthcare Organizations generally does not welcome standby kits at home, our teams have found them to be quite effective in helping patients and caregivers to manage at home. Of course, kits should be provided only after careful instruction and training on their use.

Common Barriers

Team Faith

Initially, Team Faith struggled to meet patients' pain goals. The team found that many patients were setting unrealistic goals, hoping for a pain level of zero when their condition would indicate that some discomfort would remain. Other patients refused to take medications, making pain management impossible. To counter this, Team Faith worked with nursing staff to address the challenge of patients who refused medication or who had set unrealistic pain levels. The team provided information about pain management to all patients and their families and wrote a script to help nurses manage conversations about pain control. Team Faith made sure that doctors talked to patients who had refused medications. Team Faith also found that drug delivery times were sometimes greater than eight hours, a finding that led to keeping standby kits in the home.

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