Pain and Symptom Management and Care of the Actively Dying Patient
Sets how the Agency meets each patient’s right to effective pain management and symptom control: assessing pain and other symptoms with standard tools, planning interventions in the plan of care, treating and reassessing, escalating a symptom crisis through the on-call system to continuous home care or general inpatient care, palliative sedation as a last resort, and caring for the actively dying patient and the family.
About this policy
- Policy number
- DC-HSP-PAIN-01
- Version
- 1.0
- Main rule
- 42 CFR §418.52(c)(1)
- Library
- Washington, DC hospice · 60 policies
- Category
- Clinical tasks
- Sections
- 18
In short
- Every patient has the right to effective pain and symptom control. Ask about pain at every visit.
- Use the 0 to 10 scale, or a behavior scale such as PAINAD if the patient cannot tell you.
- Check within 1 hour whether a breakthrough dose worked, and record it.
- If pain stays above the patient’s goal twice in a row, call the physician the same day.
- Teach families to call us day or night on (202) 555-0199 for new or worse symptoms.
- Aides: tell the nurse during the visit if the patient grimaces, moans or is restless.
What's inside
18 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (42 CFR §418.52(c)(1))
- 5. Assessing Pain and Symptoms
- 6. Planning Care
- 7. Treating and Reassessing
- 8. Symptom Crises and Escalation
- 9. Medication That May Shorten Life and Palliative Sedation
- 10. Care of the Actively Dying Patient
- 11. Responsibilities
- 12. Records and Compliance Monitoring
- 13. Staff Training
- 14. References
- 15. Related Policies and Forms
- 16. Approval
- 17. Revision History
An inspector may ask
- How do you assess pain in a patient who cannot tell you about it?
- Show me how the plan of care for this patient addresses pain and each other distressing symptom.
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