Final Care Coordination Plan: Pain Management Essay

Final Care Coordination Plan: Pain Management Essay

Final Care Coordination Plan: Pain Management Essay

Final Care Coordination Plan: Pain Management

Pain management is a growing health concern due to barriers faced in providing effective treatment interventions and concerns about opioid dependence and addiction to opioid analgesics. Inadequate pain management occurs due to concerns by health providers regarding over-managing pain, which contributes to implementing inadequate pain relief measures (Cohen et al., 2020). Inadequate pain control results in persistent pain and complications from under-controlled pain such as delirium, depression, disrupted social interactions, reduced occupational functioning, and suicidal thoughts. In this regard, this paper presents a care coordination plan on pain management, including patient-centered interventions for pain management, ethical decisions, and priorities for care coordinators.

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Patient-Centered Health Interventions and Timelines for Care Delivered

Health issues identified in pain management include inadequate pain assessment, inadequate pain management, and side effects of opioid drugs. Inadequate pain assessment results in the failure of health providers to understand the cause of a patient’s pain, which helps determine the best pain management interventions (Romm et al., 2021). Inadequate pain assessment will be addressed by implementing effective pain assessment strategies for each patient. Health providers will be required to obtain pain history, use pain assessment tools, assess physiological and behavioral responses to pain, and document pain assessment findings (Cohen et al., 2020). Pain assessment will be conducted on the first encounter with a patient and every four hours for patients with pain symptoms. Resources for pain assessment include American Pain Society Current Guidelines, The American Society of Pain Management Nursing guidelines on pain assessment in the nonverbal patient, and Geriatric Nursing Protocols for Best Practice.

Inadequate pain management will be addressed by health providers implementing the appropriate pain control measures, including pharmacological and non-pharmacological interventions. Within one hour of assessing pain in a patient, providers will be required to apply the WHO analgesic ladder to select pain relief measures for each patient based on the pain assessment findings. The WHO analgesic ladder outlines the type of analgesics to prescribe based on the severity of pain (Romm et al., 2021). In addition, evaluation of the effect of analgesics will be essential in promoting adequate pain management. Health providers will be required to assess the effect of analgesics on each patient. Assessment will be based on a drug’s onset of action. For instance, the effect of IV opioids will be evaluated every 15–30 minutes, while oral opioids and non-opioids will be evaluated 45–60 minutes after drug administration (Romm et al., 2021). Resources for pain management include pain management guidelines by the Health Care Association of New Jersey (HCANJ), American Society of Perianesthesia Nurses (ASPAN) Pain and Comfort Clinical Guideline, and Clinical Practice Guideline for the Management of Postoperative Pain; by the Veterans Health Administration.

The issue of opioids will be addressed through safe and appropriate opioid prescribing. Concerns about opioid dependency by providers limit them from employing adequate pain control measures resulting in inadequate pain management. Clinicians will be advised to begin with low opioid doses and titrate to comfort to ensure they are safely administered (Bonnie et al., 2019). In every patient in the outpatient clinics, clinicians will be required to assess patients on opioid analgesics for risk of opioid substance use disorder (Bonnie et al., 2019).  Besides, health providers will conduct an opioid trial by designing safe and effective opioid trials for a patient with a severe illness. Resources for opioid prescription include the ANA course on APRN Pharmacology Today: Safe Prescribing of Opioids, Health Education on Opioid and Non-opioid Analgesia during Surgery, and SAMHSA’s Opioid Overdose Prevention Toolkit.

Ethical Decision in Designing Patient-Centered Health Interventions

The above interventions will improve pain management practices and thus promote better patient outcomes and improved patient satisfaction with care. Pain assessment interventions will be a vital step to providing effective pain management. Appropriate pain management approaches will promote adequate pain control, improve patients’ health outcomes, and increase patient satisfaction (Cohen et al., 2020). Furthermore, safe and appropriate opioid prescribing will promote adequate pain control in patients with severe illnesses and reduce incidences of opioid dependency (Bonnie et al., 2019). Assessment of patients for opioid dependency will help identify patients at risk of opioid substance use disorder and take necessary actions promptly.

Decisions involving patient care interventions should be steered by ethical principles of beneficence, nonmaleficence, respect for autonomy, and justice. Beneficence and nonmaleficence are crucial in ensuring the quality and safety of patient care interventions and promoting the maximum benefit from these interventions (Hansson & Fröding, 2020). As a result, patient-centered interventions should be founded on best practices to promote the best possible outcomes without compromising patient safety. Ethical principles of autonomy, beneficence, and nonmaleficence create uncertainty about the patient care decisions proposed above (Hansson & Fröding, 2020). For example, what will be the ethical implications if health providers do not seek consent before conducting pain assessment?  For patients who overrate their pain, will we be upholding beneficence or causing more harm when they are administered placebos? In patients at risk of opioid abuse, will we respect their right to autonomy when we reduce the dosage yet they are requesting higher dosages? Besides, will reducing opioid doses in patients with pain but at risk of dependency promote good or harm?

Relevant Health Policy Implications for the Coordination and Continuum of Care

The Affordable Care Act (ACA) seeks to enhance care coordination and continuum of care in healthcare settings. A number of sections in the ACA contain care coordination programs pertinent to care coordinators in geriatrics (Kominski et al., 2017). Furthermore, the ACA seeks to improve the integration of patient care to promote continuity in healthcare. It contains provisions of care coordination under Medicaid and Medicare to enhance coordination of care by aligning incentives for quality care and moving towards better-integrated care. The Medicare program has a provision, the Community-Based Care Transitions Program (CCTP). CCTP reviews healthcare models for enhancing the transition of patients from the hospital setting to other patient care settings (Kominski et al., 2017). It seeks to reduce readmission rates of geriatric patients and decrease the high Medicare expenses related to readmission by enhancing coordination and care continuum. Implementing the CCTP provision can improve the transition of care of geriatrics with terminal illnesses and promote effective pain control, thus reducing readmissions from complications caused by inadequate pain control.

Another Medicaid provision is the Health Homes for Chronic Conditions. The Health Home provision permits states to establish a Health Home that coordinates health care for individuals with multiple chronic conditions and adverse mental illnesses (Kominski et al., 2017). Implementing the Medicaid’s Health Home provision can enhance the care coordination and continuation of care for patients with chronic pain related to terminal illnesses such as cancer.

Priorities That a Care Coordinator Would Establish When Discussing the Plan with a Patient and Family Member

The care plan for a patient in pain will need changes based on the proposed health interventions to promote better pain management. The changes in the management plan for a patient in pain will include regular pain assessment, modifications in pharmacological therapy based on pain severity and response to pain. A care coordinator’s priorities when discussing the management plan with the patient include first meeting the client’s health needs (Cohen et al., 2020). The priority needs, in this case, would be to alleviate pain since it interferes with a person’s overall functioning and impairs the quality of life.

The care coordinator should discuss the patient’s treatment preferences in order to provide care that is acceptable and culturally appropriate to the patient. A patient’s pain management preferences may be influenced by their previous experience with pain control measures and beliefs about pain (Bonnie et al., 2019). Consequently, the coordinator should be well-versed with these preferences and plan care that aligns with them. Changes in a patient’s pain management plan may be required if pain control is not adequately achieved. Besides, changes may be needed if the interventions compromise a patient’s safety or have adverse effects.

Aligning Teaching Sessions to the Healthy People 2030 Document

Best practices on pain management should guide patient education on pain control measures. The Healthy People 2030 goal concerning chronic pain is to minimize chronic pain and the misuse of prescription pain medications (ODPHP, 2020). Teaching sessions can be aligned to the Healthy People 2030 goal of minimizing chronic pain by educating patients on non-pharmacological measures to alleviate pain. In addition, teaching sessions should educate individuals on the various adverse effects of using opioids, such as opioid misuse (Bonnie et al., 2019). The teaching sessions should also focus on enhancing opioid prescribing practices among providers, improving safe disposal of unused opioids, and increasing the prescription of non-opioid analgesics to decrease opioid misuse.

Conclusion

Health issues in pain management include inadequate pain assessment, inadequate pain management, and side effects of opioid drugs. Pain assessment interventions help establish whether a patient’s underlying condition or disorder is improving or worsening and if the pain relief measures are effective. Opioid analgesics are associated with side effects of dependency. Interventions to address the health issues will include implementing appropriate pain assessment strategies, providing pain relief measures based on pain severity, and assessing patients for risk of opioid abuse.

References

Bonnie, R. J., Schumacher, M. A., Clark, J. D., & Kesselheim, A. S. (2019). Pain management and opioid regulation: Continuing public health challenges. American Journal of Public Health, 109(1), 31-34. https://doi.org/10.2105/AJPH.2018.304881

Cohen, S. P., Baber, Z. B., Buvanendran, A., McLean, B. C., Chen, Y., Hooten, W. M., … & Phillips, C. R. (2020). Pain management best practices from multispecialty organizations during the COVID-19 pandemic and public health crises. Pain Medicine, 21(7), 1331-1346. https://doi.org/10.1093/pm/pnaa127

Hansson, S. O., & Fröding, B. (2020). Ethical conflicts in patient-centered care. Clinical Ethics, 1477750920962356. https://doi.org/10.1177/1477750920962356

Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s Impacts on Access to Insurance and Health Care for Low-Income Populations. Annual review of public health, 38, 489–505. https://doi.org/10.1146/annurev-publhealth-031816-044555

ODPHP. (2020). Chronic pain. https://health.gov/healthypeople/objectives-and-data/browse-objectives/chronic-pain

Romm, M. J., Ahn, S., Fiebert, I., & Cahalin, L. P. (2021). A Meta-Analysis of Group-Based Pain Management Programs: Overall Effect on Quality of Life and Other Chronic Pain Outcome Measures, with an Exploration into Moderator Variables that Influence the Efficacy of Such Interventions. Pain Medicine, 22(2), 407-429. https://doi.org/10.1093/pm/pnaa376

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This paper is based off my Assessment 1, which was the preliminary care Coordination on pain management. I have attached all instructions with my assessment 1 paper.
Writer 1165 did my first one and I’m wondering if that writer can do this one as well I didn’t know if that would be easier. If not no biggie