D320. Pain Management

Policy Statement

This organisation recognises that everybody experiences pain at some time in their lives, often as a result of acute injury, post-operative pain, or as a symptom of an illness or condition. The task of medicine and healthcare is usually to treat injuries and illnesses and to relieve pain. However, some pain is resistant to treatment and may be chronic in nature. In addition, people may have different tolerance of pain and psychological experiences of pain. {{org_field_name}} recognises that many people who use services will be able to verbalise or indicate the level of pain they feel, while others may not.

{{org_field_name}} believes in providing high-quality evidence based care, including pain management, for each person based upon their needs as determined by a full needs assessment and recorded in an individual personalised plan of care. Each plan will be will be drawn up in full partnership between {{org_field_name}} and the person who uses services. Relatives, carers and advocates will be included in the care planning process as required by the individual and where determined as part of a best interests assessment under the Mental Capacity Act.

While it recognises that pain may be an inevitable part of an illness or condition, people have every right to have their pain managed and to be as pain free as possible. {{org_field_name}} will therefore work as closely as possible with an individual’s doctor and healthcare providers to do all it can to eliminate or manage pain.

Aim of the Policy

This policy is intended to set out the values, principles and policies underpinning this organisation’s approach to the support it should provide for peoples pain management. {{org_field_name}} believes that people who use their services have the right to the highest quality, compassionate care.

Managing Pain

In this organisation:

pain management needs will be included in any initial needs assessment, by a person trained to do such assessments. A person’s experience of pain, and any treatments or interventions needed to alleviate their pain, will be recorded in an individual’s plan of care and reviewed on a regular basis
the right to be free of pain, or where pain is chronic, to have that pain managed to be as pain free as possible, is considered to be an essential part of treating people with compassion and helping them to live with dignity
where a person develops a condition or illness that brings with it pain, or where their original condition or illness changes and their experience of pain changes, then their plan of care will be reviewed accordingly. Such changes will be agreed with the person, or their families or carers or advocates, on the basis of joint work with their healthcare provider or their doctor
care staff will be trained to be aware of changes in the condition of people who use {{org_field_name}}s and to report and make note of any changes to relevant others. In the case of pain management care staff will work closely with healthcare providers or doctors to provide for the individual’s needs
professional advice relating to the management of a person’s healthcare conditions, including their pain, will be sought and acted upon and any aids or equipment needed will be provided in partnership with other appropriate services
care staff will be proactive in taking opportunities to enable people to express their feelings about whether or not they are in pain and whether that pain has changed. Their care will be regularly reviewed, including their experience of pain and their psychological health in response to pain
appropriate interventions will be carried out for people identified as being in pain as agreed with the individual and set out in their plan of care. This may include help with the administration of prescribed pain control medication, where they require such help, or help with taking appropriate non-prescribed pain control medication, such as paracetamol, as required
all interventions involving help with taking medication will be conducted in full compliance with {{org_field_name}}’s medication administration and management policies and procedures
mild pains, such as headaches, are best treated with drugs such as paracetamol or a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen. These are usually bought over the counter from a pharmacist and self-administered. Where a person needs help with obtaining or taking such medication this should be provided with reference to the appropriate policy
people living with conditions such as dementia may have difficulty in expressing feelings of pain but have the same rights as anybody else to have their pain managed. Care staff will be trained in recognising the signs and symptoms of unidentified pain in such individuals. They should use the PAIN model and, where there is a suspicion that the person may be in pain, a referral made to the relevant GP or healthcare professional:

pick up on mood: a person’s mood may change, becoming tense or on edge, or resistant to care
assess verbal cues: a person may shout out, groan or scream
inspect facial expressions: may include frowning, sadness or crying, grimacing or fright
notice body language: may include guarding parts of the body, bracing, flinching, rubbing or holding.

pain as a result of conditions such as cancer and during end of life illnesses is well recognised. In all such cases pain must be managed to help the person to be as pain-free as possible. This will usually be provided by district nurses or specialist end of life care nurses as part of an agreed plan of care and according to established palliative care guidelines and best practice. Care staff in {{org_field_name}} should make every effort to support such interventions
with the persons agreement, any changes in pain levels will be referred to their GP or referred to a healthcare provider involved in their care, such as a district nurse, as appropriate. All people who use services must be registered with a local GP
primary Care Networks will be required to offer medication reviews/ medicines optimisations (previously known Structured Medication Reviews or SMR’s) to people prescribed opioids and gabapentinoids, traditionally used to treat epilepsy, but also found to be an effective treatment for neuropathic pain but may be addictive as can opioids.

Training

All new staff should be encouraged to read the policy on healthcare and individuals plans as part of their induction process. Existing staff will be offered training covering basic information about providing healthcare, including sessions on care planning and on the recording of notes. Staff will be trained to be observant for expressions of pain or discomfort and report these, especially if they represent a change in a person’s condition.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}

Reviewed on: {{last_update_date}}

Next review date: this policy is reviewed annually (every 12 months). When needed, this policy is also updated in response to changes in legislation, regulation, best practices, or organisational changes.

D320. Pain Management