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Frequency of Pain (M0420) interfering with
activity or movement identifies the frequency with
which pain interferes with patient’s activities,
with treatment if prescribed.
The
most important thing is ensuring your staff
consistently understands the question and knows how
to answer it correctly. One of the obstacles to
overcome is realizing that a patient may have
pain all the time but that doesn’t mean it
interferes with activities or movement. Further
assessment and observation are required to make that
determination. This can be very confusing so here
are some tips:
Medications
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Review your
patient’s medications for the presence of
medication (prescribed and over the counter)
used for pain or joint disease. If medications
are present, continue your assessment for pain
interference. Pain that is well controlled with
treatment may not interfere with activity or
movement at all.
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Pain medication side
effects (constipation, nausea, drowsiness),
which may affect your patient, are not
addressed. Only consider the effect of the
medication on your patient’s pain.
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Since Louisiana has
one of the highest per capita usages of
prescription medications, special attention
should be directed to drugs which should be
potentially avoided in the elderly. Drugs such
as meperidine (Demerol), meprobamate (for
anxiety), and pentazocine (Talwin) are a few of
those drugs. If your patient is taking any of
them, you may consider discussing with their
health care provider the possibility of
changing.
Observation
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Observe your
patient’s ability to perform ADLs and IADLs. Do
they take longer to complete a task? Do they
perform a task less frequently? Do they require
assistance to perform a task?
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If your patient is
non-verbal or unresponsive, observe facial
expression for frowning or gritting teeth.
Monitor their heart rate, respiratory rate,
perspiration, pallor, pupil size, and
irritability. Use of analog pain scales is also
helpful.
Assessment
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Explore the presence
of pain. When is it most severe? Which
activities does pain interfere with? How
frequently does it interfere with activity or
movement?
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If your patient
restricts activity to be pain-free, they have
pain interfering with activity. Assess for the
frequency their activities are limited by pain
even if they are pain free due to the activity
restriction.
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Pain doesn’t have to
completely prevent an activity from occurring.
It merely has to interfere. Don’t overlook
seemingly unimportant details, such as your
patient who delays trips to the bathroom because
it’s painful to get up or walk.
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Utilize a
standardized formal pain assessment tool
appropriate to the patient’s ability to
verbalize severity of pain. Proposed changes to
the OASIS tool may include items for pain
assessment and intervention.
Proper and consistent assessment is important in
managing your patient’s health status. We can
provide you with the tools to improve performance
and increase efficiency while still providing
patient centered care. For additional
intervention tools,
click
here to view RESOURCES
and download LHCR developed
brochures and posters that may be useful for
in-servicing staff on the importance of consistent
assessment.
For
additional intervention tools, visit
www.medqic.org.
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