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Joint Statement on Pain Management

Posted on: Thursday, 5 January 2006, 06:00 CST

By Coble, Dan

As part of its ongoing mission to protect the health, safety, and welfare of the public in Florida and to implement the patient safety agenda advocated by the Institute of Medicine and other groups, the Board of Nursing initiated an effort to address the issue of pain management. Working with other regulatory boards, a meeting was held in Tallahassee this fall, hosted by the Board of Osteopathic Medicine. As a result of that meeting, the following Joint Statement on Pain Management was approved by representatives of the Boards of Medicine, Nursing, Osteopathic Medicine, and Pharmacy on September 19, 2005. The full Board of Nursing approved the joint statement at the October 13, 2005 meeting in Kissimmee.

JOINT STATEMENT OF PAIN MANAGEMENT

The Florida Boards of Medicine, Nursing, Osteopathic Medicine, and Pharmacy recognize that principles of quality medical practice dictate that the people of the state of Florida have access to appropriate and effective pain relief. The appropriate application of up-to-date knowledge and treatment modalities can serve to improve the quality of life for those patients who suffer from pain as well as reduce the morbidity and costs associated with untreated or inappropriately treated pain; including non-treatment, under- treatment, over-treatment, and the continued use of ineffective treatments.

It is, therefore, incumbent upon Florida physicians, nurses and pharmacists to work cooperatively and effectively to address the dimensions of pain and to provide maximum pain relief with minimal side effects. Towards that end and in the interest of public protection, the Florida Boards of Medicine, Osteopathic Medicine, Nursing and Pharmacy issue the following joint statement.

To effectively assist patients in the management of pain, health care professionals should, within their scope of practice:

* Consistently and thoroughly assess all patients for pain. If pain is reported, the pain should be evaluated with a complete history and physical with laboratory and diagnostic testing, if indicated;

* Work collaboratively in a multi-disciplinary approach to develop and implement an individualized, written treatment plan utilizing pharmacologie and non-pharmacologic interventions with specific objectives for the patient;

* Regularly evaluate the effectiveness of the treatment plan, using a consistent, developmentally appropriate, standardized pain scale, and make adjustments as needed;

* Document all aspects of pain assessment and care in a timely, clear, consistent, complete and accurate manner;

* Anticipate and effectively manage side effects of pain medications;

* Provide adequate and culturally appropriate information to patients and family members or caregivers to support patients in making informed decisions and participate in the management of their pain;

* Be aware of the risks of diversion and abuse of controlled substances and take appropriate steps to minimize these risks.

* Recognize individuals with chemical dependency may experience pain requiring medications, including opioids, and may require specialized management;

* Consult with, and refer patients to, other providers when appropriate;

* Develop organization-appropriate and evidence-based policies and protocols for pain management;

* Become and remain knowledgeable regarding effective pain management; and

* Comply with all state and federal laws and regulations regarding prescribing, dispensing, and administering legend drugs, including controlled substances.

The Florida Boards of Medicine, Nursing, Osteopathic Medicine, and Pharmacy also recognize that concerns of drug diversion hinders quality medical practice and access to appropriate effective pain relief for the citizens of the state of Florida.

Towards that end and in the interest of public protection, the Florida Boards of Medicine, Osteopathic Medicine, Nursing and Pharmacy issue the following joint statement.

To effectively assist health care practitioners in the management of patient pain care and in order to effectively address prescription drug diversion the state of Florida must:

Develop a statewide electronic controlled substance prescription monitoring system that could be used by practitioners to assist them in treating patient pain as well as drug abuse.

Dan Coble

Dan Coble, RN PhD

Executive Director

Florida Board of Nursing

Copyright Florida Nurses Association Dec 2005

Source: Florida Nurse, The

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