Subject(s)
Chronic Pain/therapy , Health Plan Implementation/organization & administration , National Health Programs , Pain Management/methods , Quality of Health Care/organization & administration , Adult , Germany , Humans , Interdisciplinary Communication , Intersectoral Collaboration , Palliative Care/organization & administration , Societies, Medical , Societies, NursingABSTRACT
BACKGROUND: High healthcare needs are evident for pain caused by cancer. Those affected are not only looking for help in acute inpatient structures but also for a much larger part in outpatient care structures. To avoid mistreatment, undertreatment or overtreatment of pain in people with cancer, it is necessary to differentiate the tasks and roles of different providers while highlighting the specific aspects of pain management within the given network structures. MATERIALS AND METHODS: Aspects, such as pain assessment and the necessary scope of action in pain treatment are illustrated from the perspective of nurses from home care services, primary physicians as well as the general or special ambulatory palliative care (AAPV or SAPV) on the basis of initial survey results and a documentation analysis. RESULTS: Ambulatory care nurses (93 %) and primary caregivers (64 %) use pain assessment scales. The kind of scales used varies. The ability to provide adequate pain care for patients in the immediate care situation is reported as given by more than half of the nurses (56.6 %). CONCLUSIONS: In order to ensure an adequate pain therapy targeted interprofessional coordination is required between outpatient and primary physicians with respect to aspects of pain assessment, scope of action and accessibility.
Subject(s)
Cooperative Behavior , Delivery of Health Care, Integrated/organization & administration , Interdisciplinary Communication , Neoplasms/complications , Neoplasms/physiopathology , Pain Management/methods , Patient Care Team/organization & administration , Ambulatory Care/organization & administration , Germany , Health Services Needs and Demand/organization & administration , Home Care Services/organization & administration , Humans , Pain Measurement/methods , Palliative Care/organization & administration , Primary Health Care/organization & administrationABSTRACT
Inadequate pain care in health care facilities is still a major concern. Due to structural and organizational shortcomings the potential of modern analgesia is far from being exhausted. The project "Action Alliance Pain-free City Münster" is designed to analyze the multiprofessional pain management in health care facilities in the model City of Münster in an epidemiologic study and aims to optimize pain management in accordance with nursing standards and medical guidelines. Hospitals, nursing homes, outpatient nursing services, hospices and pain care centers will be examined. After an analysis of the current state on the basis of a pre-test, the necessary optimization measures will be developed and implemented. Subsequently, the pain management will be reevaluated in a post-test. In partly still unexplored health care areas of Germany, epidemiologic data will be generated, barriers to the implementation of standards and guidelines revealed and measures of improvements developed and tested. In addition, interface problems between the evaluated sectors will be identified. In this article the objective and the methods of the project are described.
