{"ref":"NC-HSP-PAIN-01","title":"Pain and Symptom Management and Care of the Imminently Dying Patient","category":"Hospice care","summary":"Sets how the Agency assesses, plans, treats and reassesses pain and other symptoms, responds to a symptom crisis, and cares for the patient and family when death is near, so that each patient's drug regimen gives optimal symptom control (10A NCAC 13K .0801(e)) and, if the Agency is Medicare-certified, each patient receives effective pain management and symptom control (42 CFR §418.52(c)(1)).","inShort":["Ask about pain and other symptoms at every nursing visit and use the same pain scale each time.","For a patient who cannot tell you, watch for signs of pain such as frowning, moaning or restlessness, and tell the nurse.","After any change in treatment, check again whether it worked and write down the result.","Families can call (919) 555-0199 at any hour when symptoms are out of control.","When death is near, explain what the family may see, keep the patient comfortable and remind them to call us, not 911."],"primaryCitation":"10A NCAC 13K .0801(e)","citations":["G.S. 131E-201(8)","10A NCAC 13K .0801(e)","10A NCAC 13K .0501(1)(a)(i), (v), (vi)","10A NCAC 13K .0402(b)(5), (6)","10A NCAC 13K .0701(a)"],"federalCitations":["42 CFR §418.52(c)(1)","42 CFR §418.54(c)","42 CFR §418.56(c)(1)","42 CFR §418.100(c)(2)","42 CFR §418.204(a)"],"surveyorAsks":["How do you assess pain in a patient who cannot tell you about it?","Show me the pain and symptom interventions in this patient's care plan and the reassessment after the last dose change."],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (G.S. 131E-201(8); 10A NCAC 13K .0801(e); 42 CFR §418.52(c)(1))","5. Assessing Pain and Symptoms","6. Planning Care","7. Treating and Reassessing","8. Symptom Crises and Escalation","9. Care of the Imminently Dying Patient","10. Palliative Sedation","11. Medication Safety in the Home","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":"nc-hospice","state":"North Carolina","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}}