New JCAHO Pain Care
Treatment Standards

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has developed new standards for acute pain care. These new standards call upon hospitals, home care agencies, long-term care facilities, behavioral health facilities, outpatient clinics, and health plans to:

• Recognize the right of patients to appropriate assessment and management of their pain
• Assess pain in all patients
• Record the results of the assessment in a way that facilitates regular reassessment and follow-up
• Educate relevant providers in pain assessment and management
• Determine competency in pain assessment and management during
• Establish policies and procedures that support appropriate prescription or ordering of pain medications
• Ensure that pain does not interfere with participation in rehabilitation
• Educate patients and their families about the importance of effective pain management
• Include patients’ needs for symptom management in the discharge planning process
• Collect data to monitor the appropriateness and effectiveness of pain management

These standards are implemented in hospitals accredited by JCAHO.

Pain Assessment and Management

A helpful guide for pain control and relief. "It's Your Right"!

If you are in pain please speak up.

Tell the staff when your pain first starts. Do not wait until the pain is severe. Staff members will do all they can to minimize your discomfort. Your doctor and nurse will work together to understand you pain level. They'll check your medication, your condition and are available to talk with you.

You are an essential member of the healthcare team and a partner in the healthcare process.

Hospitals should be assesing and managing patient pain.

Treating pain, often called pain management in hospitals, is an important part of your treatment both in the hospital and in physician offices.

Help us measure pain: the fifth and “different” vital sign.

Along with measuring your blood pressure, pulse, temperature and breathing your doctors and nurses will measure your pain in order to treat it.

Pain however is different than these other these other signs. Only YOU can tell us about your pain and describe it. Here are some way to describe pain...

Rate Your Pain

Where’s your pain?

Tell us about your pain.

Describe your pain with your doctor and nurse. Some helpful words you may use are:

• Aching
• Burning
• Excruciating
• Exhausting
• Gnawing
• Miserable
• Nagging
• Numb
• Penetrating
• Sharp
• Shooting
• Stabbing
• Tender
• Throbbing
• Tiring
• Unbearable

Also tell us when you are in pain and what effect the pain has on you.

• If your pain is occasional of continuous.
• What time of day your pain is worst: morning, evening or nighttime.
• What makes your pain less.
• What makes your pain worse.
• If you currently use any treatments or medicines for pain and how effective are they.
• If your pain makes it harder for you to walk, be active, sleep, sit work, enjoy life, eat, and be with family or friends (or a combination).
• If you are constipated, sleepy, nauseous,, or have a dry mouth or other symptoms.
• What activities would you want to resume if you can reduce your pain

Newborns and young children also experience pain that can interfere with recovery. Parents know their children best and can evaluate changes in behavior that may indicate pain. Please share concerns about your child’s comfort level with his or her medical team so an appropriate treatment plan can be initiated.

Many people feel that if they about pain, they are weak or will be viewed as complainers. Often, people who are in severe pain try to talk about something else.

Here are some non-verbal pain indicators:

• Facial wrinkling, blinking eyes, grimacing
• Guarding and area of the body
• Crying, moaning
• Decrease in social interaction
• Change in routines
• Aggression, like hitting or biting
• Increase in body movements, such as more squirming
• Irritability, increased confusion

What types of pain treatments are used?

• Oral medications are used for mild to moderate pain.
• IV medications are used for moderate to severe pain.
• Patient controlled analgesia (PCA) -- delivering medication through an intravenous tube -- lets you push a button to deliver the right amount of pain medication for immediate relief. Your doctor prescribes the medication and nurses make sure the PCA is set to deliver the correct dose periodically. PCAs are use for moderate to severe pain. (If you do not feel pain relief call your nurse. The dosage may need to be adjusted.) The machine has a safety feature so that you cannot receive too much medication.
• Epidural analgesia administers medications by a continuous drip through a small catheter inserted into the epidural space in your back. This is used for abdominal and chest surgeries or lower back pain.
• Peripheral nerve blocks numb painful areas with local medications.
• Intramuscular injections -- or shots in a muscle, usually given in the hip or the thigh -- are used for moderate to severe pain.

Most of the above pain treatments are appropriate for both children and adults.

Each medical situation is different

Depending on your medical situation--including how pain medication may affect you--the doctor may advise you to let pain take it’s course, or recommend alternative methods (physical therapy or exercise) or medications to manage the pain.

See what works for you

Other ways to control pain may include:

• Bathing, massage, or cold or hot packs
• Watching TV, playing a game humming or listening to music
• Muscle relaxation, deep breathing


Side effects of pain medication may include:

• Itching
• Drowsiness
• Difficulty with urination
• Nausea and vomiting
• Constipation

You need to tell your doctor or nurse of any side effects you notice.