Clinical Guideline. Pain Assessment and Management Guidance for All Wards and Units. Register No: Status: Public. Contributes to CQC Outcome 4.

Size: px
Start display at page:

Download "Clinical Guideline. Pain Assessment and Management Guidance for All Wards and Units. Register No: Status: Public. Contributes to CQC Outcome 4."

Transcription

1 Pain Assessment and Management Guidance for All Wards and Units Type: Register No: Status: Public Clinical Guideline Developed in Response to: Best Practice Contributes to CQC Outcome 4.9 Consulted With Post/Committee/Group Date Dr Alexander-Williams Pain Consultants 15/9/14 Dr Tom Durcan (Lead for Acute Pain) Lynne Mustard Pain Service Manager 15/9/14 Bharvi Patel Pain Specialist Pharmacist 15/9/14 Professionally Approved By Lead Consultant, IPMS Dr Alexander-Williams 17/9/14 Version Number 2.0 Issuing Directorate Pain Service Ratified By Document Ratification Group Ratified on 25th September 2014 Trust Board Sign Off date October 2014 Implementation Date 29th September 2014 Next Review Date September 2017 Author/Contact for Information Lynne Mustard, Clinical Nurse Specialist, Pain Management Policy to be followed by (target staff) Medical and nursing staff in contact with in patients Distribution Method Hard copies distributed to all wards and depts. Available electronically Related Trust Policies (to be read in conjunction Policy for the Use of Medicines with) Policy for the prevention of infection Policy for the protection of vulnerable adults Acute Pain Assessment and Management 3 months-16years (10045) Document review history Review No Authored/Reviewed by Review Date April Jayne Somerset September

2 Index 1. Purpose 2. Staff & Training 3. Scope of Practice 4. Policy 5. Analgesia 6. Infection Control 7. Non-Compliance with this Guideline 8. Audit & Monitoring 9. Communication & Implementation 10. References Appendices Appendix 1 Pain/Sedation and Nausea Measurement Tool Appendix 2 Analgesic stepladder 2

3 1. Purpose of Guideline 1.1 This guideline is intended to provide guidance for all medical, nursing and therapy staff in fundamental principles of ward-based pain assessment and management of noncomplex pain. 2. Staff and Training 2.1 Medical, nursing and therapy staff are expected to have an understanding of the need for regular assessment of pain and the clinical importance of treating pain promptly and safely. 2.2 The IPMS (Integrated Pain Management Service) is available for advice and consultation via the pager system, and through the PAS referral system. Information, guidelines and policy are available on the Trust intranet. 2.3 Training and education is provided by the IPMS, both formally and informally for all clinical staff. 2.4 Overall responsibility for ward-based pain management practice is that of the ward manager. It is the individuals responsibility to identify training needs and liaise with their senior to address these. 3. Scope of Practice 3.1 Every adult and child patient admitted to wards within the Trust or awaiting assessment, treatment or investigations within the emergency assessment wards has the right to pain management based on effective and regular assessment. For Children also refer to Acute Pain Assessment Management for Children 3 months -16yrs. 4. Policy 4.1 Full pain assessment must be recorded as part of the admissions procedure for every patient. This includes: pain history, existence of chronic (long term) painful conditions, acute episodes and their frequency, duration, site and severity, nature of pain, what helps/worsens the pain, and current analgesic drugs. 4.2 Pain scores are the fifth vital sign, and should be recorded at least twice a day while the patient is in the hospital. (See appendix 1). Greater frequency of assessment is indicated if pain is uncontrolled, and when analgesic responses require regular evaluation: i.e. up to hourly. 4.3 Additional pain assessment is essential to determine analgesic needs for patients undergoing painful procedures such as dressings, manipulation or physiotherapy. 4.4 Management of pain must be individually tailored according to the patient s requirements, own choices and clinical status. A holistic approach is required, addressing anxieties and queries as part of the pain management. 4.5 Patients requiring expert support to establish objective pain assessment and management, such as vulnerable adults, non-english speaking, cognitively impaired and children, must be referred to the appropriate specialty as indicated. 3

4 5. Analgesia 5.1 Analgesic prescriptions and administration must be evidence-based, and multi-modal, taking into consideration variability in individual responses, and contra-indications or cautions for certain clinical conditions. (See Appendix 2 for simple analgesic stepladder) 5.2 All staff prescribing or administering analgesia are responsible, and accountable for understanding the actions and adverse effects of the drugs given. 5.3 Analgesic drugs prescribed for Trust patients are provided from formulary in accordance with the Medicines Management Policy and Controlled drugs Policy Analgesic needs must be evaluated regularly, as clinically indicated, and tailored accordingly. Escalation or reduction of dosage, change or cessation of drugs must be based on clinically sound evaluation. 5.5 TTAs ( To Take Away ) must be provided according to patient need, and further management advice stated clearly in the GP discharge letter. 5.6 Patient with complex pain issues which are unresponsive to standard analgesics may be referred to the IPMS for advice and further management. 5.7 Sources of information for analgesic doses and actions are: Pharmacy dept., IPMS, BNF (British National Formulary). 6. Infection Control 6.1 Staff coming into patient contact during assessment and administration of treatment and analgesics must conform to Trust infection prevention standards and guidance, by adhering to hand-washing standards between contacts. 7. Non-Compliance with this Guideline 7.1 Failure to provide regular assessment and effective pain management is a breach of patient rights, and has clinical and non-clinical repercussions: Patient satisfaction and well-being is compromised Accountability and professional responsibility is breached Clinical risk is increased, due to multi-systemic influence of pain Delayed discharge from hospital decreases Trust efficiency and increases risk of hospital-inquired infection 7.2 A risk event form should be completed and submitted to the Risk Management Department for non-compliance with this guideline. 8. Audit & Monitoring 8.1 Yearly audit of compliance to regular pain assessments on wards is carried out by the IPMS. 8.2 Incidence of clinical risk or patient complaints resulting from non-compliance of this guideline is recorded via the central risk events database and PALS if involved and a quarterly review of incidence of breaches will be undertaken by the IPMS based on these data, to identify trends, learn from reports and establish necessary actions. 4

5 8.3 The IPMS manager and lead consultant will liaise at corporate level to put strategies in place to address issues. 9.0 Communication and Implementation 9.1 Corporate services will ensure that the guideline is uploaded to the intranet and the website and notified to staff via Focus. 9.3 All link nurses will be informed of updated guidelines at regular meetings for them to disseminate to their areas/wards. 9.4 Medical staff will be informed of revised guidelines via senior medical staff within the IPMS at audit meetings and twice yearly teaching sessions for all FY1 and FY2 doctors. 10. References Dougherty L, Lister S (eds). The Royal Marsden Hospital Manual of Clinical Nursing Procedures, 6th ed. 2004, Blackwell Oxford (pub) Myths and misconceptions about opiates McCaffrey M, Pasero C (eds). In: Pain, Clinical Manual, 2nd ed. 1999, Mosby London (pub) DoH Essence of Care. Benchmarks for Prevention and Management of Pain. October 2010 Chronic pain Policy Coalition 2007: A new pain manifesto: Pain the 5th vital sign. Australian and New Zealand College of Anaesthetists and Chronic Pain Coalition ANZA Nurses knowledge of pain. Journal of Clinical Nursing;16:6, ; 2008 Older people are less likely to report pain: Hall-Lloyd and Larson 2006 Services for patients with pain. Clinical Standards advisory Group (CSAG) DoH 2000 Acute Pain Services: British Pain Society 2000 Code of Conduct: NMC Professional accountability: GMC 5

6 Appendix 1 Pain/Sedation and Nausea Measurement Tool This tool can be used for all patients requiring analgesia. Movement = eg patient attempts to touch the opposite side of the bed or deep breathe. All patients should be asked about pain at least bd (twice daily), regardless of analgesia prescription/intake. Pain Score Score 0 (none) No pain at rest, no pain on movement Score 1 (mild) No pain at rest, mild pain on movement Score 2 (moderate) Intermittent pain at rest, moderate pain on movement Score 3 (severe)* Continuous pain at rest, severe pain on movement * Call doctor or pain team Sedation Score Score 0 (none) Awake and fully responsive Score 1 (mild) Occasionally drowsy, easy to rouse Score 2 (moderate) Frequently drowsy, easy to rouse Score 3 (severe)* Somnolent, difficult to rouse * Call doctor or anaesthetist Nausea Score Score 0 Score 1 Score 2 Score 3 No nausea Nausea Vomiting Refuses treatment 6

7 Appendix 2 Analgesic stepladder SEVERE PAIN (Score 3) Epidural analgesia or morphine PCA or SC/IM protocol or oramorph/oxycodone plus NSAID plus paracetamol 1g QDS regularly MODERATE PAIN (Score 2) Low dose morphine or tramadol 400mg in 24hrs plus NSAID plus paracetamol 1g x 6hrly regularly MILD PAIN (Score 1) paracetamol max 4g-day NSAID * It is advisable not to give codeine or tramadol with other opiate based products. Avoid tramadol in epileptics; caution in patients receiving drugs that reduce seizure threshold. * NSAIDs should not be prescribed for more than 5 days in the first instance: caution in the elderly. Do not prescribe NSAIDs in the presence of renal impairment, dehydration, heart failure, active bleeding or a history of peptic ulceration. 7

The Pharmacological Management of Cancer Pain in Adults. Clinical Audit Tool

The Pharmacological Management of Cancer Pain in Adults. Clinical Audit Tool The Pharmacological Management of Cancer Pain in Adults Clinical Audit Tool 2015 This clinical audit tool accompanies the Pharmacological Management of Cancer Pain in Adults NCEC National Clinical Guideline

More information

Support to Primary Care from Derbyshire Substance Misuse Service for prescribed / OTC drug dependence

Support to Primary Care from Derbyshire Substance Misuse Service for prescribed / OTC drug dependence Support to Primary Care from Derbyshire Substance Misuse Service for prescribed / OTC drug dependence SUMMARY 1) Derbyshire Substance misuse service provides Psycho-social treatment interventions for ALL

More information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Sedation for diagnostic and therapeutic procedures in children and young people 1.1 Short title Sedation in children and young

More information

Epidural Continuous Infusion. Patient information Leaflet

Epidural Continuous Infusion. Patient information Leaflet Epidural Continuous Infusion Patient information Leaflet April 2015 Introduction You may already know that epidural s are often used to treat pain during childbirth. This same technique can also used as

More information

Abstral Prescriber and Pharmacist Guide

Abstral Prescriber and Pharmacist Guide Abstral Prescriber and Pharmacist Guide fentanyl citrate sublingual tablets Introduction The Abstral Prescriber and Pharmacist Guide is designed to support healthcare professionals in the diagnosis of

More information

Donepezil (Aricept ), Galantamine (Reminyl XL ), Rivastigmine (Exelon ) and Memantine (Ebixa )

Donepezil (Aricept ), Galantamine (Reminyl XL ), Rivastigmine (Exelon ) and Memantine (Ebixa ) Donepezil (Aricept ), Galantamine (Reminyl XL ), Rivastigmine (Exelon ) and Memantine (Ebixa ) ESCA: For the treatment of Alzheimer s disease. SECONDARY CARE SECTION TO BE COMPLETED BY INITIATING DOCTOR

More information

Tramadol Educational Resource Materials

Tramadol Educational Resource Materials Tramadol Educational Resource Materials Audit Materials November 2013 (Updated August 2014) These educational resource materials have been prepared by a multiprofessional collaborative group, with support

More information

Collaborative Care Plan for PAIN

Collaborative Care Plan for PAIN 1. Pain Assessment *Patient s own description of pain is the most reliable indicator for pain assessment. Pain intensity to be assessed using the ESAS (Edmonton Symptom Assessment Scale) Use 5 th Vital

More information

Shared Care Guideline-Use of Donepezil, Galantamine, Rivastigmine and Memantine in Dementia

Shared Care Guideline-Use of Donepezil, Galantamine, Rivastigmine and Memantine in Dementia Shared Care Guideline-Use of Donepezil, Galantamine, Rivastigmine and Memantine in Dementia Version: 3.0 Ratified by: Medicines Committee Date ratified: 16 th November 2011 Name of originator/author: James

More information

Good Practice Guidance: The administration of medicines in domiciliary care

Good Practice Guidance: The administration of medicines in domiciliary care Good Practice Guidance: The administration of medicines in domiciliary care Medicines Management Social Care Support Team Reviewed February 2014 This guidance is based on documents that were on CQC s website

More information

Day Case Unit, Horton General Hospital Information and advice following a surgical procedure under spinal anaesthetic

Day Case Unit, Horton General Hospital Information and advice following a surgical procedure under spinal anaesthetic Oxford University Hospitals NHS Trust Day Case Unit, Horton General Hospital Information and advice following a surgical procedure under spinal anaesthetic What is a spinal anaesthetic? Spinal anaesthesia

More information

Horton Day Case Unit. Information and advice after a surgical procedure under a general anaesthetic

Horton Day Case Unit. Information and advice after a surgical procedure under a general anaesthetic Horton Day Case Unit Information and advice after a surgical procedure under a general anaesthetic Information for patients 2 Driving Anaesthetic drugs remain the body for up to 48 hours and gradually

More information

Enhanced recovery programme (ERP) for patients undergoing bowel surgery

Enhanced recovery programme (ERP) for patients undergoing bowel surgery Enhanced recovery programme (ERP) for patients undergoing bowel surgery Information for patients, relatives and carers An enhanced recovery programme (ERP) has been established at Imperial College Healthcare

More information

GENERAL PRACTICE BASED PHARMACIST

GENERAL PRACTICE BASED PHARMACIST GENERAL PRACTICE BASED PHARMACIST JOB PURPOSE Provide expertise in clinical medicines review 1 and address public health and social needs of patients in GP practices Reduce inappropriate poly-pharmacy

More information

ALCOHOL DETOXIFICATION (IN-PATIENTS) PRESCRIBING GUIDELINE

ALCOHOL DETOXIFICATION (IN-PATIENTS) PRESCRIBING GUIDELINE ALCOHOL DETOXIFICATION (IN-PATIENTS) PRESCRIBING GUIDELINE Authors Sponsor Responsible committee Ratified by Consultant Psychiatrist; Pharmacist Team Manager Medical Director Medicines Management Group

More information

Stowe School Medications Policy

Stowe School Medications Policy INTRODUCTION Most pupils will need medication at some stage of their school life. Although this will mainly be for short periods there are a few pupils with chronic conditions who may require regular medication

More information

Health Professionals Medication Policy for Registered Nurses.

Health Professionals Medication Policy for Registered Nurses. Health Professionals Medication Policy for Registered Nurses. Regularly Reviewed last update May 2010. In accordance with the NMC guidelines of the Administration on Medication, the following principles

More information

Clinical Algorithm & Preferred Medications to Treat Pain in Dialysis Patients

Clinical Algorithm & Preferred Medications to Treat Pain in Dialysis Patients Clinical Algorithm & Preferred Medications to Treat Pain in Dialysis Patients Developed by the Mid Atlantic Renal Coalition and the Kidney End of Life Coalition September 2009 This project was supported,

More information

Following minor gynaecological surgery

Following minor gynaecological surgery Following minor gynaecological surgery Exceptional healthcare, personally delivered n Following your operation you should have an adult to take you home and remain with you overnight. Transport home should

More information

National Clinical Programme in Surgery (NCPS) Care Pathway for the Management of Day Case Laparoscopic Cholecystectomy

National Clinical Programme in Surgery (NCPS) Care Pathway for the Management of Day Case Laparoscopic Cholecystectomy National Clinical Programme in Surgery (NCPS) Care Pathway for the Management of Day Case Consultant Surgeon DRAFT VERSION 0.5 090415 Table of Contents 1.0 Purpose... 3 2.0 Scope... 3 3.0 Responsibility...

More information

GUIDELINE FOR STEP-DOWN TRANSFER OF PATIENTS FROM CRITICAL CARE AREAS

GUIDELINE FOR STEP-DOWN TRANSFER OF PATIENTS FROM CRITICAL CARE AREAS GUIDELINE FOR STEP-DOWN TRANSFER OF PATIENTS FROM CRITICAL CARE AREAS This guidance does not override the individual responsibility of health professionals to make appropriate decision according to the

More information

Guidelines for the Prescribing, Supply and Administration of Methadone and Buprenorphine on Transfer of Care

Guidelines for the Prescribing, Supply and Administration of Methadone and Buprenorphine on Transfer of Care Hull & East Riding Prescribing Committee Guidelines for the Prescribing, Supply and Administration of Methadone and Buprenorphine on Transfer of Care 1. BACKGROUND Patients who are physically dependent

More information

Document Ratification Group Approved on 25 th June 2009 Trust Executive Board Date July 2009 Next Review Date June 2011

Document Ratification Group Approved on 25 th June 2009 Trust Executive Board Date July 2009 Next Review Date June 2011 Verification of Adult Death by Registered Nurses Document Type: Policy Register Number: 07016 Status Public Developed in response to: Contributes to CQC Core Standard Hospital at night and Reduction in

More information

Title. Learning from Incidents, Complaints and Claims. Description of Document

Title. Learning from Incidents, Complaints and Claims. Description of Document Title Description of Document Scope Author and designation Equality Impact Assessment (EIA) Associated Documents Supporting References Learning from Incidents, Complaints and Claims This policy identifies

More information

Code of Practice for Records Management NHSLA Risk Management Standards Contributes to Care Quality Commission: Outcome 4

Code of Practice for Records Management NHSLA Risk Management Standards Contributes to Care Quality Commission: Outcome 4 Cardiac Nurse Practitioner Clinical Operational Policy Policy Register No: 09143 Public Developed in response to: Information Governance Toolkit Code of Practice for Records Management NHSLA Risk Management

More information

Quality and Safety Programme Fractured neck of femur services

Quality and Safety Programme Fractured neck of femur services Quality and Safety Programme Fractured neck of femur services London quality standards February 2013 1 Introduction The case for change for fractured neck of femur services in London demonstrates that

More information

Local Enhanced Service Specification for the Supply of Pharmaceutical Services to Care Homes through Community Pharmacy

Local Enhanced Service Specification for the Supply of Pharmaceutical Services to Care Homes through Community Pharmacy Local Enhanced Service Specification for the Supply of Pharmaceutical Services to Care Homes through Community Pharmacy Contents: 1. Introduction and purpose 2. Period of Service 3. Aim of the Service

More information

Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine. Managing Acute Pain. A Guide for Patients.

Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine. Managing Acute Pain. A Guide for Patients. Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine Managing Acute Pain A Guide for Patients Approved by MANAGING ACUTE PAIN AGUIDE FOR PATIENTS Australian and New Zealand

More information

7 Myths Regarding Opioid Use in Pain Management. Chris Patterson, M.S.N., R.N. Muskegon Community College

7 Myths Regarding Opioid Use in Pain Management. Chris Patterson, M.S.N., R.N. Muskegon Community College 1 7 Myths Regarding Opioid Use in Pain Management Chris Patterson, M.S.N., R.N. Muskegon Community College 2 7 Myths Regarding Opioid Use in Pain Management The National Center for Health Statistics estimates

More information

POAC CLINICAL GUIDELINE

POAC CLINICAL GUIDELINE POAC CLINICAL GUIDELINE Acute Pylonephritis DIAGNOSIS COMPLICATED PYELONEPHRITIS EXCLUSION CRITERIA: Male Known or suspected renal impairment (egfr < 60) Abnormality of renal tract Known or suspected renal

More information

Epidural Management. Policy/Purpose. Scope

Epidural Management. Policy/Purpose. Scope Fluid & Medications Management Policy/Purpose... 1 Scope... 1 Associated documents... 2 General... 2 Epidural Indications... 2 Contra-indications:... 2 Educational requirements... 3 Procedural Considerations...

More information

The Medicines Policy. Chapter 2: Standards of Practice PRESCRIBING

The Medicines Policy. Chapter 2: Standards of Practice PRESCRIBING Chapter 2: Standards of Practice PRESCRIBING V2.1 Date: January 2015 CHAPTER 2 Table of Contents 6. Standards and Practice... 3 6.1. Prescribing... 3 6.1.1 Patient-Centred Prescribing... 3 6.1.2 Prescription

More information

Patient Group Directions. Guidance and information for nurses

Patient Group Directions. Guidance and information for nurses Patient Group Directions Guidance and information for nurses Patient Group Directions Guidance and information for nurses Contents Introduction 4 What is a patient group direction (PGD)? 4 When can PGDs

More information

medicineupdate Tramadol for pain Asking the right questions about new medicines Page Section 1: What tramadol is 1 Section 2: What tramadol is for 1

medicineupdate Tramadol for pain Asking the right questions about new medicines Page Section 1: What tramadol is 1 Section 2: What tramadol is for 1 medicineupdate Asking the right questions about new medicines Tramadol for pain Page Section 1: What tramadol is 1 Section 2: What tramadol is for 1 Section 3: Who can take tramadol 2 Section 4: What does

More information

Patient Group Direction Hospital: Bristol Royal Infirmary Department: UHBristol Thrombosis Service University Hospitals Bristol NHS Foundation Trust.

Patient Group Direction Hospital: Bristol Royal Infirmary Department: UHBristol Thrombosis Service University Hospitals Bristol NHS Foundation Trust. Patient Group Direction Hospital: Bristol Royal Infirmary Department: UHBristol Thrombosis Service University Hospitals Bristol NHS Foundation Trust. This Patient Group Direction (PGD) has been written

More information

Opioid Prescribing for Chronic Pain: Guidelines for Marin County Clinicians

Opioid Prescribing for Chronic Pain: Guidelines for Marin County Clinicians Opioid Prescribing for Chronic Pain: Guidelines for Marin County Clinicians Although prescription pain medications are intended to improve the lives of people with pain, their increased use and misuse

More information

patient group direction

patient group direction DICLOFENAC v01 1/8 DICLOFENAC PGD Details Version 1.0 Legal category Staff grades Approved by POM Paramedic (Non-ECP) Nurse (Non-ECP) Emergency Care Practitioner (Paramedic) Emergency Care Practitioner

More information

Nurse Practitioner Emergency Services CLINICAL PRACTICE GUIDELINE

Nurse Practitioner Emergency Services CLINICAL PRACTICE GUIDELINE Scope Nurse Practitioner Wrist/forearm injury, pain, swelling or deformity Identify patients (Emergency) CPG Medical Practitioner +/-Nurse Practitioner Compound # / obvious fracture dislocation/ dislocation

More information

Policy for the issue of permits to prescribe Schedule 8 poisons

Policy for the issue of permits to prescribe Schedule 8 poisons Policy for the issue of permits to prescribe Schedule 8 poisons May 2011 Introduction The Victorian Drugs, Poisons and Controlled Substances (DPCS) legislation sets out certain circumstances when a medical

More information

Ultram (tramadol), Ultram ER (tramadol extended-release tablets); Conzip (tramadol extended-release capsules), Ultracet (tramadol / acetaminophen)

Ultram (tramadol), Ultram ER (tramadol extended-release tablets); Conzip (tramadol extended-release capsules), Ultracet (tramadol / acetaminophen) Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.02.35 Subject: Tramadol Acetaminophen Page: 1 of 8 Last Review Date: September 18, 2015 Tramadol Acetaminophen

More information

Naltrexone Shared Care Guideline for the treatment of alcohol dependence and opioid dependance

Naltrexone Shared Care Guideline for the treatment of alcohol dependence and opioid dependance Naltrexone Shared Care Guideline for the treatment of alcohol dependence and opioid dependance Introduction Indication/Licensing information: Naltrexone is licensed for use as an additional therapy, within

More information

GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST

GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST MEDICINES MANAGEMENT STRATEGY 2006/07 ANNUAL REPORT 1. Aim An annual report on the Trust s Medicines Management Strategy is part of the requirements for Standards

More information

MELATONIN FOR SLEEP DISORDERS IN CHILDREN AND ADOLESCENTS WITH NEURODEVELOPMENTAL DISORDERS SHARED CARE GUIDELINES

MELATONIN FOR SLEEP DISORDERS IN CHILDREN AND ADOLESCENTS WITH NEURODEVELOPMENTAL DISORDERS SHARED CARE GUIDELINES MELATONIN FOR SLEEP DISORDERS IN CHILDREN AND ADOLESCENTS WITH NEURODEVELOPMENTAL DISORDERS SHARED CARE GUIDELINES Version control: Version Date Main changes/comments V1 4 June 2013 First draft circulated

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Royal Free Hospital Urgent Care Centre Royal Free Hospital,

More information

Pharmacists improving care in care homes

Pharmacists improving care in care homes The Royal Pharmaceutical Society believes that better utilisation of pharmacists skills in care homes will bring significant benefits to care home residents, care homes providers and the NHS. Introduction

More information

Elements for a public summary. VI.2.1 Overview of disease epidemiology. VI.2.2 Summary of treatment benefits

Elements for a public summary. VI.2.1 Overview of disease epidemiology. VI.2.2 Summary of treatment benefits VI.2 Elements for a public summary VI.2.1 Overview of disease epidemiology Pain is one of the most common reasons for a patient to seek medical attention. Moderate or severe intensity pain can be acute

More information

SCOTTISH PRISON SERVICE DRUG MISUSE AND DEPENDENCE OPERATIONAL GUIDANCE

SCOTTISH PRISON SERVICE DRUG MISUSE AND DEPENDENCE OPERATIONAL GUIDANCE SCOTTISH PRISON SERVICE DRUG MISUSE AND DEPENDENCE OPERATIONAL GUIDANCE 1 P a g e The following Operational Guidance Manual has been prepared with input from both community and prison addictions specialists

More information

National Chlamydia Screening Programme September 2012 PATIENT GROUP DIRECTION FOR THE ADMINISTRATION OF AZITHROMYCIN FOR CHLAMYDIA TRACHOMATIS

National Chlamydia Screening Programme September 2012 PATIENT GROUP DIRECTION FOR THE ADMINISTRATION OF AZITHROMYCIN FOR CHLAMYDIA TRACHOMATIS PATIENT GROUP DIRECTION FOR THE ADMINISTRATION OF AZITHROMYCIN FOR CHLAMYDIA TRACHOMATIS Below is a template that can be used to produce a local patient group direction (PGD) for the administration of

More information

NHS Professionals. Guidelines for the Administration of Medicines

NHS Professionals. Guidelines for the Administration of Medicines NHS Professionals Guidelines for the Administration of Medicines Introduction The control of medicines in the United Kingdom is primarily through the Medicines Act (1968) and associated British and European

More information

WITHDRAWAL OF ANALGESIA AND SEDATION

WITHDRAWAL OF ANALGESIA AND SEDATION WITHDRAWAL OF ANALGESIA AND SEDATION Patients receiving analgesia and/or sedation for longer than 5-7 days may suffer withdrawal if these drugs are suddenly stopped. To prevent this happening drug doses

More information

Collaboration Anesthesia

Collaboration Anesthesia HPC hpcconnection.ca Nursing Neuro - axial Analgesia cross sector Pharmacists Intractable patient centered Opioids Interventional Consensus Collaboration Anesthesia Physicians epidural evidence based Intraspinal

More information

ALBERTA S HEALTH SYSTEM PERFORMANCE MEASURES

ALBERTA S HEALTH SYSTEM PERFORMANCE MEASURES ALBERTA S HEALTH SYSTEM PERFORMANCE MEASURES 1.0 Quality of Health Services: Access to Surgery Priorities for Action Acute Care Access to Surgery Reduce the wait time for surgical procedures. 1.1 Wait

More information

RGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND

RGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND RGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND Monitor patient on the ward to detect trends in vital signs and to manage accordingly To recognise deteriorating trends and request relevant medical/out

More information

Keeping patients safe when they transfer between care providers getting the medicines right

Keeping patients safe when they transfer between care providers getting the medicines right PART 1 Keeping patients safe when they transfer between care providers getting the medicines right Good practice guidance for healthcare professions July 2011 Endorsed by: Foreword Taking a medicine is

More information

Spinal cord stimulation

Spinal cord stimulation Spinal cord stimulation This leaflet aims to answer your questions about having spinal cord stimulation. It explains the benefits, risks and alternatives, as well as what you can expect when you come to

More information

MEDICINES MANAGEMENT STANDARD OPERATING PROCEDURE (MMSOP018) Preparation of Medication Administration Record (MAR) Charts

MEDICINES MANAGEMENT STANDARD OPERATING PROCEDURE (MMSOP018) Preparation of Medication Administration Record (MAR) Charts MEDICINES MANAGEMENT STANDARD OPERATING PROCEDURE (MMSOP018) Preparation of Medication Administration Record (MAR) Charts Any deviation in practice from this procedure must be discussed with the Community

More information

! # # # %# # & # ( ) +,. / 01 2 3 4 % # )., 0,, 5((/ + 6 0,67 8,+,, + 6,67, 7 6

! # # # %# # & # ( ) +,. / 01 2 3 4 % # )., 0,, 5((/ + 6 0,67 8,+,, + 6,67, 7 6 ! # # # %# # & # ( ) +,. / % # ).,,, ((/ +,7 8,+,, +,7, 7 9 Title : Non-Medical Prescribing in Palliative Care: A Regional Survey. Corresponding Author: Dr Lucy Ziegler l.e.ziegler@leeds.ac.uk Senior Research

More information

Adjunctive psychosocial intervention. Conditions requiring dose reduction. Immediate, peak plasma concentration is reached within 1 hour.

Adjunctive psychosocial intervention. Conditions requiring dose reduction. Immediate, peak plasma concentration is reached within 1 hour. Shared Care Guideline for Prescription and monitoring of Naltrexone Hydrochloride in alcohol dependence Author(s)/Originator(s): (please state author name and department) Dr Daly - Consultant Psychiatrist,

More information

A Policy for the. Administration of Medicines. in Schools and. Educational Establishments

A Policy for the. Administration of Medicines. in Schools and. Educational Establishments DEPARTMENT OF EDUCATION AND RECREATION SERVICES A Policy for the Administration of Medicines in Schools and Educational Establishments CONTENTS Rationale and Aim 1 1. The Education Authority 2 2. Schools

More information

Guidelines for Developing a Protocol/Procedure for the Administration of Medication

Guidelines for Developing a Protocol/Procedure for the Administration of Medication Appendix 1 Guidelines for Developing a Protocol/Procedure for the Administration of Medication The Child Care (Pre-School Services) (N0 2) Regulations 2006 and Explanatory Guide to Requirements and Procedures

More information

MANAGEMENT OF CHRONIC NON MALIGNANT PAIN

MANAGEMENT OF CHRONIC NON MALIGNANT PAIN MANAGEMENT OF CHRONIC NON MALIGNANT PAIN Introduction The Manitoba Prescribing Practices Program (MPPP) recognizes the important role served by physicians in relieving pain and suffering and acknowledges

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Borough of Poole - Civic Centre Borough of Poole, Civic Centre,

More information

VA SAN DIEGO HEALTHCARE SYSTEM MEMORANDUM 118-28 SAN DIEGO, CA

VA SAN DIEGO HEALTHCARE SYSTEM MEMORANDUM 118-28 SAN DIEGO, CA GUIDELINES FOR PATIENT-CONTROLLED ANALGESIA (PCA) AND PATIENT- CONTROLLED EPIDURAL ANALGESIA (PCEA) FOR ACUTE PAIN MANAGEMENT 1. PURPOSE: To assure the safe and effective use of patient controlled analgesia

More information

Anna Barker anna.barker@monash.edu

Anna Barker anna.barker@monash.edu School of Public Health and Preventive Medicine Use of guideline recommendations Anna Barker anna.barker@monash.edu Overview Knowledge translation Objectives Methods The problem of falls Knowledge to action

More information

Policy Document Control Page

Policy Document Control Page Policy Document Control Page Title Title: Covert Administration of Medicines Version: Version 6 Reference Number: CL37 Supersedes Supersedes: Version 5 Description of amendment(s): Originator 3.5 Clarification

More information

Policy Document Control Page. Title: Protocol for Mental Health Inpatient Service Users who require care in the Pennine Acute Hospital

Policy Document Control Page. Title: Protocol for Mental Health Inpatient Service Users who require care in the Pennine Acute Hospital Policy Document Control Page Title: Protocol for Mental Health Inpatient Service Users who require care in the Pennine Acute Hospital Version: 5 Reference Number: CL25 Supersedes Supersedes: Protocol for

More information

Appendix to Tennessee Department of Health: Tennessee Clinical Practice Guidelines for Outpatient Management of Chronic Non- Malignant Pain

Appendix to Tennessee Department of Health: Tennessee Clinical Practice Guidelines for Outpatient Management of Chronic Non- Malignant Pain Appendix to Tennessee Department of Health: Tennessee Clinical Practice Guidelines for Outpatient Management of Chronic Non- Malignant Pain Division of Workers Compensation 04.01.2015 Background Opioids

More information

QUALITY ACCOUNT 2015-16

QUALITY ACCOUNT 2015-16 QUALITY ACCOUNT 2015-16 CONTENTS Part 1 Chief Executive s statement on quality... 3 Vision, purpose, values and strategic aims... 4 Part 2 Priorities for improvement and statement of assurance... 5 2.1

More information

Dabigatran: Amber Drug Guidance for the prevention of stroke and systemic embolism in patients with non-valvular AF

Dabigatran: Amber Drug Guidance for the prevention of stroke and systemic embolism in patients with non-valvular AF Leeds Dabigatran: Amber Drug Guidance for the prevention of stroke and systemic embolism in patients with non-valvular AF Amber Drug Level 3 (amber drug with monitoring requirements) We have started your

More information

GUIDELINES FOR THE CONTROL AND ADMINISTRATION OF MEDICINES DOMICILIARY CARE AGENCIES

GUIDELINES FOR THE CONTROL AND ADMINISTRATION OF MEDICINES DOMICILIARY CARE AGENCIES GUIDELINES FOR THE CONTROL AND ADMINISTRATION OF MEDICINES DOMICILIARY CARE AGENCIES January 2009 Contents Page Number 1.0 Introduction 3 2.0 Background 4 3.0 Criteria 5 3.1 Referral 5 3.2 Levels of assistance/consent

More information

2. The prescribing clinician will register with the designated manufacturer.

2. The prescribing clinician will register with the designated manufacturer. Clozapine Management Program Description Magellan of Arizona Pharmacy Program Background: Magellan Health Services of Arizona recognizes the importance of a clozapine program. Clozapine received increased

More information

NSQHS Standard 1 Governance

NSQHS Standard 1 Governance NSQHS Standard 1 Governance Definitions sheet Governance Audit Tools Definitions Contents 1. Open Disclosure Program Page 1 2. ACUTE Clinical Record Audit Tools Page 2 -----------------------------------------------------------------------------------

More information

Pain Management after Surgery Patient Information Booklet

Pain Management after Surgery Patient Information Booklet Pain Management after Surgery Patient Information Booklet PATS 509-15-05 Your Health Care Be Involved Be involved in your healthcare. Speak up if you have questions or concerns about your care. Tell a

More information

Guidelines for Nurse Led HIV Clinic

Guidelines for Nurse Led HIV Clinic Guidelines for Nurse Led HIV Clinic Produced and approved by (Committee and Date) Kieran Sharkey Ratified by (Committee and Date) Reviewed Review date: Guidelines for Nurse Led HIV Clinic Introduction

More information

WORCESTERSHIRE MENTAL HEALTH PARTNERSHIP NHS TRUST GUIDELINES FOR THE MANAGEMENT OF ADULT OPIATE DEPENDENT PATIENTS IN THE ACUTE HOSPITAL SETTING

WORCESTERSHIRE MENTAL HEALTH PARTNERSHIP NHS TRUST GUIDELINES FOR THE MANAGEMENT OF ADULT OPIATE DEPENDENT PATIENTS IN THE ACUTE HOSPITAL SETTING WORCESTERSHIRE MENTAL HEALTH PARTNERSHIP NHS TRUST GUIDELINES FOR THE MANAGEMENT OF ADULT OPIATE DEPENDENT PATIENTS IN THE ACUTE HOSPITAL SETTING This policy should be read in conjunction with Worcestershire

More information

Negligence and patient safety. Mark Gagan

Negligence and patient safety. Mark Gagan Negligence and patient safety Mark Gagan Intended Learning outcomes Following this presentation the participant should be able to define accountability, negligence and the triad of negligence Determine,using

More information

Review of Pharmacological Pain Management

Review of Pharmacological Pain Management Review of Pharmacological Pain Management CHAMP Activities are possible with generous support from The Atlantic Philanthropies and The John A. Hartford Foundation The WHO Pain Ladder The World Health Organization

More information

Information for Pharmacists

Information for Pharmacists Page 43 by 42 CFR part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. Information for Pharmacists SUBOXONE (buprenorphine HCl/naloxone HCl

More information

Nurse Initiated Medications Procedure

Nurse Initiated Medications Procedure 1. Purpose This Procedure is performed as a means of ensuring the safe administration of therapeutic medication to patients in accordance with all legislative and regulatory requirements. 2. Application

More information

The Horton General Hospital, Day Case Unit After a laparoscopic cholecystectomy Information for patients

The Horton General Hospital, Day Case Unit After a laparoscopic cholecystectomy Information for patients The Horton General Hospital, Day Case Unit After a laparoscopic cholecystectomy Information for patients Today you have had a procedure called laparoscopic cholecystectomy. This means that your gall bladder

More information

NHS ONEL and NELFT Shared Care Guidelines. Management of medications for Alzheimer s disease. Patient Name : Date of Birth: NHS No:

NHS ONEL and NELFT Shared Care Guidelines. Management of medications for Alzheimer s disease. Patient Name : Date of Birth: NHS No: NHS ONEL and NELFT Shared Care Guidelines Management of medications for Alzheimer s disease DOCUMENT TO BE SCANNED INTO ELECTRONIC RECORDS AND FILED IN NOTES Patient Name : Date of Birth: NHS No: Name

More information

POST-TEST Pain Resource Professional Training Program University of Wisconsin Hospital & Clinics

POST-TEST Pain Resource Professional Training Program University of Wisconsin Hospital & Clinics POST-TEST University of Wisconsin Hospital & Clinics True/False/Don't Know - Circle the correct answer T F D 1. Changes in vital signs are reliable indicators of pain severity. T F D 2. Because of an underdeveloped

More information

Quality standard Published: 11 June 2015 nice.org.uk/guidance/qs89

Quality standard Published: 11 June 2015 nice.org.uk/guidance/qs89 Pressure ulcers Quality standard Published: 11 June 2015 nice.org.uk/guidance/qs89 NICE 2015. All rights reserved. Contents Introduction... 6 Why this quality standard is needed... 6 How this quality standard

More information

Version Number: 5. Patient Group Direction originally drawn up by: Reviewed by: Patient Group direction authorised by: Medical Lead

Version Number: 5. Patient Group Direction originally drawn up by: Reviewed by: Patient Group direction authorised by: Medical Lead PATIENT GROUP DIRECTION (PGD) FOR THE SUPPLY AND/OR ADMINISTRATION OF NALOXONE HYDROCHLORIDE INJECTION BY REGISTERED NURSES WORKING IN COMMUNITY AND INPATIENT SUBSTANCE MISUSE TEAMS Version Number: 5 Patient

More information

INFORMATION GOVERNANCE POLICY

INFORMATION GOVERNANCE POLICY INFORMATION GOVERNANCE POLICY Version: 3.2 Authorisation Committee: Date of Authorisation: May 2014 Ratification Committee Level 1 documents): Date of Ratification Level 1 documents): Signature of ratifying

More information

Seven steps to patient safety The full reference guide. Second print August 2004

Seven steps to patient safety The full reference guide. Second print August 2004 Seven steps to patient safety The full reference guide Second print August 2004 National Patient Safety Agency Seven steps to patient safety 113 Appendix Four F Examples of events according to severity

More information

Summary of EWS Policy for NHSP Staff

Summary of EWS Policy for NHSP Staff Summary of EWS Policy for NHSP Staff For full version see CMFT Intranet Contact Sister Donna Egan outreach coordinator bleep 8742 Tel: 0161 276 8742 Introduction The close monitoring of patients physiological

More information

PG Certificate / PG Diploma / MSc in Clinical Pharmacy

PG Certificate / PG Diploma / MSc in Clinical Pharmacy PG Certificate / PG Diploma / MSc in Clinical Pharmacy Programme Information September 2014 Entry School of Pharmacy Queen s University Belfast Queen s University Belfast - Clinical Pharmacy programme

More information

Alternatives to Hospital: Models of Integrated Care

Alternatives to Hospital: Models of Integrated Care Alternatives to Hospital: Models of Integrated Care Tom Bowen The Balance of Care Group www.balanceofcare.com IMA Health 2007, London, UK 2 April 2007 Projects taking whole systems approach Sheffield Designed

More information

Cancer Pain. What is Pain?

Cancer Pain. What is Pain? Cancer Pain What is Pain? The International Association for the Study of Pain says that pain is "an unpleasant sensory and emotional experience associated with actual or potential tissue damage." Pain

More information

Root Cause Analysis Investigation Tools. Concise RCA investigation report examples

Root Cause Analysis Investigation Tools. Concise RCA investigation report examples Root Cause Analysis Investigation Tools Concise RCA investigation report examples www.npsa.nhs.uk/nrls Acute service example Mental health example Ambulance service example Primary care example Acute service

More information

Acute Pain Management in the Opioid Dependent Patient. Maripat Welz-Bosna MSN, CRNP-BC

Acute Pain Management in the Opioid Dependent Patient. Maripat Welz-Bosna MSN, CRNP-BC Acute Pain Management in the Opioid Dependent Patient Maripat Welz-Bosna MSN, CRNP-BC Relieving Pain in America (IOM) More then 116 Million Americans have pain the persists for weeks to years $560-635

More information

Opioid Treatment Agreement

Opioid Treatment Agreement Opioid Treatment Agreement 1. I understand that my provider and I will work together to find the most appropriate treatment for my chronic pain. I understand the goals of treatment are not to eliminate

More information

Clinical Teaching Fellow (UCLMS) in association with Private Practice Unit The Royal Free Hospital Foundation NHS Trust.

Clinical Teaching Fellow (UCLMS) in association with Private Practice Unit The Royal Free Hospital Foundation NHS Trust. Clinical Teaching Fellow (UCLMS) in association with Private Practice Unit The Royal Free Hospital Foundation NHS Trust. JOB TITLE: Clinical Teaching Fellow (CTF) and Resident Medical Officer (RMO) ACCOUNTABLE

More information

Understanding Your Pain

Understanding Your Pain Toll Free: 800-462-3636 Web: www.endo.com Understanding Your Pain This brochure was developed by Margo McCaffery, RN, MS, FAAN, and Chris Pasero, RN, MS, FAAN authors of Pain: Clinical Manual (2nd ed.

More information

Medicines reconciliation on admission and discharge from hospital policy April 2013. WHSCT medicines reconciliation policy 1

Medicines reconciliation on admission and discharge from hospital policy April 2013. WHSCT medicines reconciliation policy 1 Medicines reconciliation on admission and discharge from hospital policy April 2013 WHSCT medicines reconciliation policy 1 Policy Title Policy Reference Number Medicines reconciliation on admission and

More information

The Outpatient Knee Replacement Program at Orlando Orthopaedic Center. Jeffrey P. Rosen, MD

The Outpatient Knee Replacement Program at Orlando Orthopaedic Center. Jeffrey P. Rosen, MD The Outpatient Knee Replacement Program at Orlando Orthopaedic Center Jeffrey P. Rosen, MD Anesthesia Pain Management Post-Op / Discharge Protocols The Orlando Orthopaedic Center Joint Replacement Team

More information

SAFE PAIN MEDICATION PRESCRIBING GUIDELINES

SAFE PAIN MEDICATION PRESCRIBING GUIDELINES Prescription drug abuse has been declared an epidemic by the Centers for Disease Control. According to 2012 San Diego Medical Examiner data, the number one cause of non-natural death is due to drug overdoses

More information

A Patient s Guide to PAIN MANAGEMENT. After Surgery

A Patient s Guide to PAIN MANAGEMENT. After Surgery A Patient s Guide to PAIN MANAGEMENT After Surgery C o m p a s s i o n a n d C o m m i t m e n t A Patient s Guide to Pain Management After Surgery If you re facing an upcoming surgery, it s natural to

More information

Over the Counter Drugs (OTCs): Considerations for Physical Therapy Practice in Canada

Over the Counter Drugs (OTCs): Considerations for Physical Therapy Practice in Canada Background Over the Counter Drugs (OTCs): Considerations for Physical Therapy Practice in Canada The use of medications or drugs by non-physician health professionals is evolving and is linked to collaboration

More information