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 2013 | Full implementation achieved |
March 2014 | One year review |
October 2014 | Revised forms posted |
Pilot Sites
Central Coast Local Health District | Gosford Hospital |
Hunter New England Local Health District | Tamworth Rural Referral Hospital |
South Eastern Sydney Local Health District | Prince of Wales Hospital |
Western Sydney Local Health District | Westmead Hospital |
Implementation Sites
Central Coast Local Health District | Central Coast Local Health District |
Far West Local Health District | Far West Local Health District |
Hunter New England Local Health District | Hunter New England Local Health District |
Illawarra Shoalhaven Local Health District | Illawarra Shoalhaven Local Health District |
Justice Health and Forensic Mental Health Network | Justice Health and Forensic Mental Health Network |
Mid North Coast Local Health District | Mid North Coast Local Health District |
Murrumbidgee Local Health District | Murrumbidgee Local Health District |
Nepean Blue Mountains Local Health District | Nepean Blue Mountains Local Health District |
Northern NSW Local Health District | Northern NSW Local Health District |
Northern Sydney Local Health District | Northern Sydney Local Health District |
South Eastern Sydney Local Health District | South Eastern Sydney Local Health District |
South Western Sydney Local Health District | South Western Sydney Local Health District |
Southern NSW Local Health District | Southern NSW Local Health District |
St Vincent's Health Network | St Vincent's Health Network |
Sydney Local Health District | Sydney Local Health District |
Western NSW Local Health District | Western NSW Local Health District |
Western Sydney Local Health District | Western Sydney Local Health District |
Key Date (location)
Pilot Site
Implementation Site
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