PICU Pain Assessment (NQF 0341)

EMeasure Name PICU Pain Assessment EMeasure Id F13FC49F-BC05-47A7-B130-AEA9E4D6B439
Version number 1 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
Risk Adjustment
None
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.
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.
Improvement notation
Measurement duration
12 month(s)
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)
Definition
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

Table of Contents


Population criteria

Data criteria (QDS Data Elements)

Summary Calculation

Calculation is generic to all measures:



Measure set CLINICAL QUALITY MEASURE SET 2011-2012