NSW Standardised Pain Charts (adult)

Aim

Development and implementation of statewide charts to be used at the bedside when delivering Patient Controlled Analgesia (PCA), ketamine infusions and neuraxial opioid administration. To standardise practice and reduce error relating to documentation, monitoring and prescription across NSW.

Benefits

Benefits include improved safety and quality of care for patients.

Summary

The initiative involved an extensive consultancy phase with a group of interested Clinical Nurse Consultants (CNCs) and anaesthetists, as well as discussions with the Clinical Excellence Commission (CEC), State Forms Committee and Medication Safety Expert Advisory Committee (MSEAC).

Draft charts were developed and piloted in four NSW hospitals. Much effort was taken to ensure alignment with existing protocols in the Standard Adult General Observation (SAGO) chart.

One thousand charts of each type were audited and analysed, with several changes made as a result of the pilot.

In response, an education package was developed in collaboration with the CEC. This package has been placed on the ACI website, together with an implementation package.

Background

The ACI, together with the Pain Interest Group - Nursing Issues (PIGNI) and expert clinicians in the field of pain management have standardised three pain charts for use in NSW hospitals.

These new pain charts aim:

  • To provide a consistent framework and format for prescribing, recording and monitoring adult patients receiving opioid medications via a Patient Controlled Analgesia (PCA),a neuraxial route, or patient receiving a ketamine infusion
  • To provide ’track and trigger’ principles consistent with ’Between the Flags’ documentation which recognises the deteriorating adult patient associated with the administration of opioids

To improve safety by reducing the incidence of adverse events associated with PCA, ketamine infusions and neuraxial opioid administration.

Partnerships

  • Clinical Excellence Commission (CEC)
  • Health Education and Training Institute (HETI)
  • Local Health Districts
  • NSW Therapeutic Advisory Group (NSW TAG)
  • Pain Interest Group Nursing Issues (PIGNI)

Key Dates

March 2013Full implementation achieved
    March 2014One year review
      October 2014

      Revised forms posted

        Pilot Sites

        Central Coast Local Health DistrictGosford Hospital
        Hunter New England Local Health DistrictTamworth Rural Referral Hospital
        South Eastern Sydney Local Health DistrictPrince of Wales Hospital
        Western Sydney Local Health DistrictWestmead Hospital

        Implementation Sites

        Central Coast Local Health DistrictCentral Coast Local Health District
        Far West Local Health DistrictFar West Local Health District
        Hunter New England Local Health DistrictHunter New England Local Health District
        Illawarra Shoalhaven Local Health DistrictIllawarra Shoalhaven Local Health District
        Justice Health and Forensic Mental Health NetworkJustice Health and Forensic Mental Health Network
        Mid North Coast Local Health DistrictMid North Coast Local Health District
        Murrumbidgee Local Health DistrictMurrumbidgee Local Health District
        Nepean Blue Mountains Local Health DistrictNepean Blue Mountains Local Health District
        Northern NSW Local Health DistrictNorthern NSW Local Health District
        Northern Sydney Local Health DistrictNorthern Sydney Local Health District
        South Eastern Sydney Local Health DistrictSouth Eastern Sydney Local Health District
        South Western Sydney Local Health DistrictSouth Western Sydney Local Health District
        Southern NSW Local Health DistrictSouthern NSW Local Health District
        St Vincent's Health NetworkSt Vincent's Health Network
        Sydney Local Health DistrictSydney Local Health District
        Western NSW Local Health DistrictWestern NSW Local Health District
        Western Sydney Local Health DistrictWestern Sydney Local Health District

        Evaluation

        Formal Evaluation has occurred in 2014. Revised forms are now available on the ACI website.

        Related Initiatives

        This project is related to the NSW Pain Clinic Referral Form and Process.

        Further Details

        For more information go to NSW Standardised Pain Charts (adult) on the ACI website.

        Contact

        Jenni Johnson
        Manager, Pain Management Network
         jenni.johnson@health.nsw.gov.au
         02 9464 4636

        Chris Shipway
        Director, Primary Care and Chronic Services
         chris.shipway@health.nsw.gov.au
         02 9464 4603

        Page Top | Added: 7 November 2013 | Last modified: 15 December 2014

        ACI
        Status:
        Contact:
        Jenni Johnson
        Manager, Pain Management Network
        Email
        02 9464 4636
        Share: