Jeanette McNeill|Gwen Sherwood|Patricia L. Starck
The hidden error of mismanaged pain: a systems approach
The University of Texas Health Science Center at Houston|The University of Texas Health Science Center at Houston|The University of Texas Health Science Center at Houston
undertreatment pain resulting physiological psychosocial economic consequences continues despite targeted improvement approaches starck et al propose systems framework study pain management errors secondary analysis examined pain outcomes hospitalized inpatients determine factors predicting adequate pain management data collected 964 hospitalized adult patients southwestern united states american pain society patient outcome questionnaire demographic chart audit form used collect data pain management index pmi computed participants results revealed 30 patients undertreated pain 675 reporting severe worst pain ratings 7 010 scale nonwhites elderly women significantly higher pain ratings higher proportions negative pmi scores logistic regression predicted adequate pain management based analgesic rating ethnicity age educational level 089 accuracy study findings support conceptualizing mismanagement pain medical error intervention model describes use systems approach identify high risk patients ensure effective pain management practices