eMeasure Name | PICU Pain Assessment | eMeasure Id | F13FC49F-BC05-47A7-B130-AEA9E4D6B439 |
Version number | 1 | eMeasure Set Id | 68BABFA0-7991-428F-8A8B-A6293D34C29B |
Available Date | No information | Measurement Period | January 1, 20xx through December 31, 20xx |
Measure Steward | National Association of Children's Hospitals and Related Institutions | ||
Endorsed by | National Quality Forum | ||
Description | Percentage of PICU patients receiving pain assessment on admission. | ||
Copyright | |||
Measure scoring | Proportion | ||
Measure type | Process | ||
Stratification | None |
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Risk Adjustment | None |
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Data Aggregation | |||
Rationale | Pain assessment and management are critical to the well-being and care experience of children, and there is significant evidence of under-treatment of pain. Clinical practice guidelines call for the routine assessment of pain. Routine and frequent assessment of pain is not only humane and kind, it may also prevent over dosing, over treatment and unnecessary therapy which would result in prolonged length of stay and economic impact. |
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Clinical Recommendation Statement | Clinical guidelines recommend periodic assessment of pain. For example, the American Academy of Pediatrics (AAP) Guideline on the Prevention and Management of Pain in the Neonate – An Update (Available: http://www.guideline.gov/content.aspx?id=10169&search=pain+management#Section420) recommends that neonates should be assessed for pain routinely and before and after procedures. The Royal College of Nursing (in The Recognition and Assessment of Acute Pain in Children – Available: http://www.rcn.org.uk/__data/assets/pdf_file/0004/269185/003542.pdf) recommends that pain be assessed, recorded and re-evaluated at regular intervals, which should be determined according to the individual needs of the patient. |
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Improvement notation | No information |
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Measurement duration | 12 month(s) |
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Reference | Clinical Practice Guidelines: The recognition and assessment of acute pain in children Update of full guideline (Available: http://www.rcn.org.uk/__data/assets/pdf_file/0004/269185/003542.pdf) |
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Definition | Initial Patient Population(s): Pediatric Intensive Care Unit (PICU) patients |
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Definition | Denominator(s): All PICU admissions during time period |
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Definition | Denominator Exclusion(s): N/A |
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Definition | Numerator(s): Number of patients assessed for pain on admission to PICU |
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Definition | Denominator Exception(s): N/A |
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Guidance | The date/time recorded for the "Risk category/assessment: pain assessment" element must be the date/time the pain assessment was actually performed. Two types of pain scales are commonly used: behavioral/observational scales and self-report tools. Behavioral/observational tools are the primary method for infants, children less than 3 years of age, and developmentally disabled patients. Examples include: • CRIES (Crying, oxygen Requirement, Increased vital signs, facial Expression, Sleep – available: http://painconsortium.nih.gov/pain_scales/index.html) • NIPS (Neonatal/Infants Pain Scale – available: http://www.anes.ucla.edu/pdf/assessment_tool-nips.pdf) • FLACC (Face, Legs, Activity, Crying, Consolability – available: http://painconsortium.nih.gov/pain_scales/index.html) • CHEOPS (Children's Hospital of Eastern Ontario Pain Scale – available: http://www.empainline.org/linked_site_content/pdf/CHEOPS.pdf). Examples of self-report scales include: • Wong-Baker Faces Scale (available: http://painconsortium.nih.gov/pain_scales/index.html • Bieri-modified Faces scale (available: http://www.usask.ca/childpain/fpsr/) • Numerical rating scales, such as http://www.partnersagainstpain.com/printouts/A7012AS7.pdf |
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Supplemental Data Elements | Report "Patient Characteristic: Gender" using "Gender HL7 Value Set (2.16.840.1.113883.1.11.1)"; Report "Patient Characteristic: Race" using "Race CDC Value Set (2.16.840.1.114222.4.11.836)"; Report "Patient Characteristic: Ethnicity" using "Ethnicity CDC Value Set (2.16.840.1.114222.4.11.837)"; Report "Patient Characteristic: Payer" using "Payer Source of Payment Typology Value Set (2.16.840.1.113883.3.221.5)". |
Measure set | CLINICAL QUALITY MEASURE SET 2011-2012 |