{"ref":"FL-HSP-PAIN-01","title":"Symptom Control Protocols, Pain Management and Care of the Actively Dying Patient","category":"Hospice care","summary":"Sets how the Agency controls pain and other symptoms: the medical director’s written symptom control protocols, assessment and reassessment, treatment under the plan of care, the Agency’s response standards for symptom crises, opioid safety, continuous home care and inpatient care for symptoms that cannot be managed at home, care of the actively dying patient and family, palliative sedation safeguards, and how the Agency evaluates and studies its symptom control methods.","inShort":["Ask about pain and other symptoms at every visit and call, using the same scales for everyone.","Recheck after an as-needed dose: about 30 minutes for injections, about 60 minutes for pills.","Call the physician the same day if a symptom stays above the patient’s goal for more than 24 hours.","On-call nurses return symptom calls within 15 minutes, at any hour.","Prepare families for the last days and tell them to call us, not 911, when death comes."],"primaryCitation":"Rule 59A-38.008(2)(b)9., F.A.C.","citations":["Rule 59A-38.008(2)(b)9., F.A.C.","Rule 59A-38.005(2)(c)-(d), F.A.C.","s. 400.601(7), F.S.","s. 400.609(4), F.S.","Rule 59A-38.006(5)(g), F.A.C.","s. 400.6095(8), F.S."],"federalCitations":["42 CFR §418.52(c)(1), (3)","42 CFR §418.54(c)(4)-(5)","42 CFR §418.56(c)(1)","42 CFR §418.58"],"surveyorAsks":["Show me the medical director’s written protocols for pain, nausea, vomiting and other symptoms.","How do you assess pain in a patient who cannot speak?"],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (Rule 59A-38.008(2)(b)9., F.A.C.; Rule 59A-38.005(2)(c), F.A.C.; 42 CFR §418.52(c)(1))","5. Symptom Control Protocols","6. Assessing Pain and Symptoms","7. Treating and Reassessing","8. Symptom Crises and Escalation","9. Care of the Actively Dying Patient","10. Palliative Sedation","11. Evaluating and Studying Symptom Control","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. Revision History"],"version":"1.0","sample":false,"pack":"fl-hospice","state":"Florida","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}