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Pain Management Calculator

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Pain Management Calculator Powered By Docstoc
					                                    Welcome!
                          Welcome to the Pain Management Calculator v2.0.
            This easy-to-use template is a mechanism for tracking the number of residents
                    experiencing pain during their quarterly care plan conference.

                       This workbook will assist you in tracking pain management
                      in your nursing home. Each worksheet can be accessed by
                     clicking the color-coded tab at the bottom of this workbook.
       You will need to use the scroll buttons at the bottom left of the screen to see all the tabs.


       Worksheet                                                       Description
  1            Welcome!                             A table of contents to ease workbook navigation.
  2           Instructions                 A navigation guide to task completion. Print for easy reference.
  3         Common Qs & As                 Answers to commonly asked questions. Print for easy reference.
4-15        Week 1 - Week 12                              Enter your weekly data on these tabs.
 16          Data Summary                             A summary of your data will appear in this tab.
 17             Graphs                        Graphs for your summary data will be generated in this tab.
                                        Use this tab to record changes in systems or processes implemented by
                   Changes
18                                                                  your nursing home
                                                                                                                                             Instructions
                                                                                                                        Print this worksheet for easy-to-follow instructions


                                                                  Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                                CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                                  to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:



                                                                                                               In the past 5 days, has
                                                          In the last 5 days, has   In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   In the past 5 days, the
                                                                                                              resident received non-                                                                                            In the past 5 days, the worst
                                                       resident been on scheduled   resident received PRN                                 resident experienced        experienced pain "almost        worst pain experienced
         Resident Name             Stay Type                                                                         medication                                                                                                  pain experienced on Verbal
                                                        pain medication regimen?          pain meds?                                        pain at any time?       constantly" or "frequently"?         on Numeric Scale
                                                                                                              interventions for pain?                                                                                             Descriptor Scale (J0600B)
                                                                 (J0100A)                  (J0100B)                                              (J0300)                   (1 or 2 on J0400)                 (J0600A)
                                                                                                                      (J0100C)
       Step 1: Enter each
        resident's name.
              abbey                 Long Stay                     Yes                         Yes                       Yes                        Yes                           Yes                             0                        Moderate
               bea                  Long Stay                     Yes                         Yes                       Yes                        Yes                           Yes                            10                        Moderate
                            Step 2: Select"Long Stay" or
               carl                  Long Stay                    Yes                         Yes                       Yes                        Yes                           Yes                             0                        Moderate
                            "Short Stay" from the drop
              david                  Long Stay
                                      down box.                   Yes                         Yes                       Yes                        Yes                           Yes                             0                        Moderate
              efram                 Long Stay                                                 No                   No
                                                                  No Step 3: Select "Yes" or "No" from the drop down box
                                                                                                                       as recorded for             No                            No                             10                        Moderate
              frank                 Long Stay                     No     each of the MDS 3.0 pain management items as appropriate .
                                                                                            No                   No                                No                            No                            0
                                                                                                                                                                           Step 4: Enter pain levels as recorded                          Moderate
             george                Short Stay                     Yes                         Yes                       Yes                        Yes                     for MDS 3.0 for the Numeric OR the
                                                                                                                                                                                Yes                           10                            Mild
              harry                Short Stay                     Yes                         Yes                       Yes                        Yes                         Verbal Descriptor pain scales. 0
                                                                                                                                                                                Yes                                                         Mild
               ida                 Short Stay                     Yes                         Yes                       Yes                        Yes                           Yes                             5                          Mild
              james                Short Stay                     Yes                         Yes                       Yes                        Yes                           Yes                             0                          Mild
              kurt                 Short Stay                     Yes                         Yes                       Yes                        Yes                           Yes                             4                          Mild
              larry                Short Stay                     Yes                         Yes                       Yes                        Yes                           Yes                             1                          Mild
             mimsy                 Short Stay                     Yes                         Yes                       Yes                        Yes                           Yes                            10                          Mild
                                                       Common Qs & As
Q: What is pain?
     A: CMS defines “pain” in the State Operations Manual (SOM), Appendix PP as, “an unpleasant sensory and emotional
     experience that can be acute, recurrent or persistent". Several different types of pain include:
     “Acute Pain” is generally pain of abrupt onset and limited duration, often associated with an adverse chemical, thermal or
     mechanical stimulus such as surgery, trauma and acute illness;
     “Breakthrough Pain” refers to an episodic increase in (flare-up) pain in someone whose pain is generally being managed by
     his/her current medication regimen;
     “Incident Pain” refers to pain that is typically predictable and is related to a precipitating event such as movement (e.g.,
     walking, transferring, or dressing) or certain actions (e.g., disimpaction or wound care); and
     “Persistent Pain” or “Chronic Pain” refers to a pain state that continues for a prolonged period of time or recurs more than
     intermittently for months or years.
      For more information on Pain Management in Long Term Care, please download the CMS State Operations Manual, Appendix
                              PP (http://www.cms.gov/manuals/Downloads/som107ap_pp_guidelines_ltcf.pdf).

Q: What is the campaign's goal for pain?
    A: The campaign established the goal as "Nursing home residents will receive appropriate care to prevent and minimize
    eipisodes of moderate or severe pain. Objectives for long stay and short stay are slightly different". The campaign's vision is that
    ALL nursing homes will strive toward an environment in which every resident’s pain is recognized and appropriately treated at
    the earliest possible moment and that all side effects are recognized and managed.
                                                     Common Qs & As
           5A: Long Stay (longer than 90-days) nursing home residents will receive appropriate care to prevent and minimize
           episodes of moderate or severe pain.
           - The national average of moderate or severe pain experienced by long-stay residents will be at or below 2%.
           - Also, 30% of nursing homes will regularly report rates of moderate to severe pain for long stay residents at or below 1%.
           5B: People who come from a hospital to a nursing home for a short stay will receive appropriate care to prevent and
           minimize episodes of moderate or severe pain.
           - The national average of moderate or severe pain experienced by post-acute residents will be at or below 16%.
           - Also, 30% of nursing homes will regularly report rates of moderate or severe pain for post acute residents at or below 7%.




Q: How was the Pain rate calculated on the publicly reported long stay quality measure (MDS 2.0)?
    A: Numerator: Percent of residents with moderate pain at least daily
          (J2a=2 AND J2b=2) OR horrible/excruciating pain at any frequency (J2b=3) on the target assessment.
       Denominator: All residents with a valid target assessment.
       Exclusions: Residents satisfying any of the following conditions:
       1. The target assessment is an admission (AA8a = 01) assessment.
       2. Either J2a or J2b is missing on the target assessment.
       3. The values of J2a and J2b are inconsistent on the target
         assessment.

Q. What data do I need to enter on the website?
    A: At this time, the campaign will not be collecting these data during the time that the QMs/QIs are not posted by CMS. This
    tool is designed to assist NHs to collect their own internal data and to monitor their improvement.
                                                                               Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                               to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:


                                                                                                                                                                                                  In the past 5 days, the
                                                                                                           In the past 5 days, has
                                                     In the past 5 days, has    In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   worst pain experienced      In the past 5 days, the worst
                                                                                                          resident received non-
                                                  resident been on scheduled    resident received PRN                                 resident experienced        experienced pain "almost           on Numeric Scale          pain experienced on Verbal
         Resident Name           Stay Type                                                                       medication
                                                   pain medication regimen?           pain meds?                                        pain at any time?       constantly" or "frequently"?             (J0600A)                    Descriptor Scale
                                                                                                          interventions for pain?
                                                            (J0100A)                   (J0100B)                                              (J0300)                   (1 or 2 on J0400)           (leave blank if resident             (J0600B)
                                                                                                                  (J0100C)
                                                                                                                                                                                                      unable to answer)
                                                                               Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                               to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:


                                                                                                                                                                                                  In the past 5 days, the
                                                                                                           In the past 5 days, has
                                                     In the past 5 days, has    In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   worst pain experienced      In the past 5 days, the worst
                                                                                                          resident received non-
                                                  resident been on scheduled    resident received PRN                                 resident experienced        experienced pain "almost           on Numeric Scale          pain experienced on Verbal
         Resident Name           Stay Type                                                                       medication
                                                   pain medication regimen?           pain meds?                                        pain at any time?       constantly" or "frequently"?             (J0600A)                    Descriptor Scale
                                                                                                          interventions for pain?
                                                            (J0100A)                   (J0100B)                                              (J0300)                   (1 or 2 on J0400)           (leave blank if resident             (J0600B)
                                                                                                                  (J0100C)
                                                                                                                                                                                                      unable to answer)
                                                                               Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                               to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:


                                                                                                                                                                                                  In the past 5 days, the
                                                                                                           In the past 5 days, has
                                                     In the past 5 days, has    In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   worst pain experienced      In the past 5 days, the worst
                                                                                                          resident received non-
                                                  resident been on scheduled    resident received PRN                                 resident experienced        experienced pain "almost           on Numeric Scale          pain experienced on Verbal
         Resident Name           Stay Type                                                                       medication
                                                   pain medication regimen?           pain meds?                                        pain at any time?       constantly" or "frequently"?             (J0600A)                    Descriptor Scale
                                                                                                          interventions for pain?
                                                            (J0100A)                   (J0100B)                                              (J0300)                   (1 or 2 on J0400)           (leave blank if resident             (J0600B)
                                                                                                                  (J0100C)
                                                                                                                                                                                                      unable to answer)
                                                                               Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                               to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:


                                                                                                                                                                                                  In the past 5 days, the
                                                                                                           In the past 5 days, has
                                                     In the past 5 days, has    In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   worst pain experienced      In the past 5 days, the worst
                                                                                                          resident received non-
                                                  resident been on scheduled    resident received PRN                                 resident experienced        experienced pain "almost           on Numeric Scale          pain experienced on Verbal
         Resident Name           Stay Type                                                                       medication
                                                   pain medication regimen?           pain meds?                                        pain at any time?       constantly" or "frequently"?             (J0600A)                    Descriptor Scale
                                                                                                          interventions for pain?
                                                            (J0100A)                   (J0100B)                                              (J0300)                   (1 or 2 on J0400)           (leave blank if resident             (J0600B)
                                                                                                                  (J0100C)
                                                                                                                                                                                                      unable to answer)
                                                                               Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                               to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:


                                                                                                                                                                                                  In the past 5 days, the
                                                                                                           In the past 5 days, has
                                                     In the past 5 days, has    In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   worst pain experienced      In the past 5 days, the worst
                                                                                                          resident received non-
                                                  resident been on scheduled    resident received PRN                                 resident experienced        experienced pain "almost           on Numeric Scale          pain experienced on Verbal
         Resident Name           Stay Type                                                                       medication
                                                   pain medication regimen?           pain meds?                                        pain at any time?       constantly" or "frequently"?             (J0600A)                    Descriptor Scale
                                                                                                          interventions for pain?
                                                            (J0100A)                   (J0100B)                                              (J0300)                   (1 or 2 on J0400)           (leave blank if resident             (J0600B)
                                                                                                                  (J0100C)
                                                                                                                                                                                                      unable to answer)
                                                                               Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                               to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:


                                                                                                                                                                                                  In the past 5 days, the
                                                                                                           In the past 5 days, has
                                                     In the past 5 days, has    In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   worst pain experienced      In the past 5 days, the worst
                                                                                                          resident received non-
                                                  resident been on scheduled    resident received PRN                                 resident experienced        experienced pain "almost           on Numeric Scale          pain experienced on Verbal
         Resident Name           Stay Type                                                                       medication
                                                   pain medication regimen?           pain meds?                                        pain at any time?       constantly" or "frequently"?             (J0600A)                    Descriptor Scale
                                                                                                          interventions for pain?
                                                            (J0100A)                   (J0100B)                                              (J0300)                   (1 or 2 on J0400)           (leave blank if resident             (J0600B)
                                                                                                                  (J0100C)
                                                                                                                                                                                                      unable to answer)
                                                                               Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                               to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:


                                                                                                                                                                                                  In the past 5 days, the
                                                                                                           In the past 5 days, has
                                                     In the past 5 days, has    In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   worst pain experienced      In the past 5 days, the worst
                                                                                                          resident received non-
                                                  resident been on scheduled    resident received PRN                                 resident experienced        experienced pain "almost           on Numeric Scale          pain experienced on Verbal
         Resident Name           Stay Type                                                                       medication
                                                   pain medication regimen?           pain meds?                                        pain at any time?       constantly" or "frequently"?             (J0600A)                    Descriptor Scale
                                                                                                          interventions for pain?
                                                            (J0100A)                   (J0100B)                                              (J0300)                   (1 or 2 on J0400)           (leave blank if resident             (J0600B)
                                                                                                                  (J0100C)
                                                                                                                                                                                                      unable to answer)
                                                                               Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                               to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:


                                                                                                                                                                                                  In the past 5 days, the
                                                                                                           In the past 5 days, has
                                                     In the past 5 days, has    In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   worst pain experienced      In the past 5 days, the worst
                                                                                                          resident received non-
                                                  resident been on scheduled    resident received PRN                                 resident experienced        experienced pain "almost           on Numeric Scale          pain experienced on Verbal
         Resident Name           Stay Type                                                                       medication
                                                   pain medication regimen?           pain meds?                                        pain at any time?       constantly" or "frequently"?             (J0600A)                    Descriptor Scale
                                                                                                          interventions for pain?
                                                            (J0100A)                   (J0100B)                                              (J0300)                   (1 or 2 on J0400)           (leave blank if resident             (J0600B)
                                                                                                                  (J0100C)
                                                                                                                                                                                                      unable to answer)
                                                                               Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                               to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:


                                                                                                                                                                                                  In the past 5 days, the
                                                                                                           In the past 5 days, has
                                                     In the past 5 days, has    In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   worst pain experienced      In the past 5 days, the worst
                                                                                                          resident received non-
                                                  resident been on scheduled    resident received PRN                                 resident experienced        experienced pain "almost           on Numeric Scale          pain experienced on Verbal
         Resident Name           Stay Type                                                                       medication
                                                   pain medication regimen?           pain meds?                                        pain at any time?       constantly" or "frequently"?             (J0600A)                    Descriptor Scale
                                                                                                          interventions for pain?
                                                            (J0100A)                   (J0100B)                                              (J0300)                   (1 or 2 on J0400)           (leave blank if resident             (J0600B)
                                                                                                                  (J0100C)
                                                                                                                                                                                                      unable to answer)
                                                                               Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                               to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:


                                                                                                                                                                                                  In the past 5 days, the
                                                                                                           In the past 5 days, has
                                                     In the past 5 days, has    In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   worst pain experienced      In the past 5 days, the worst
                                                                                                          resident received non-
                                                  resident been on scheduled    resident received PRN                                 resident experienced        experienced pain "almost           on Numeric Scale          pain experienced on Verbal
         Resident Name           Stay Type                                                                       medication
                                                   pain medication regimen?           pain meds?                                        pain at any time?       constantly" or "frequently"?             (J0600A)                    Descriptor Scale
                                                                                                          interventions for pain?
                                                            (J0100A)                   (J0100B)                                              (J0300)                   (1 or 2 on J0400)           (leave blank if resident             (J0600B)
                                                                                                                  (J0100C)
                                                                                                                                                                                                      unable to answer)
                                                                               Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                               to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:


                                                                                                                                                                                                  In the past 5 days, the
                                                                                                           In the past 5 days, has
                                                     In the past 5 days, has    In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   worst pain experienced      In the past 5 days, the worst
                                                                                                          resident received non-
                                                  resident been on scheduled    resident received PRN                                 resident experienced        experienced pain "almost           on Numeric Scale          pain experienced on Verbal
         Resident Name           Stay Type                                                                       medication
                                                   pain medication regimen?           pain meds?                                        pain at any time?       constantly" or "frequently"?             (J0600A)                    Descriptor Scale
                                                                                                          interventions for pain?
                                                            (J0100A)                   (J0100B)                                              (J0300)                   (1 or 2 on J0400)           (leave blank if resident             (J0600B)
                                                                                                                  (J0100C)
                                                                                                                                                                                                      unable to answer)
                                                                               Care Planning & Data Tracking Worksheet for Residents Experiencing Pain

                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive appropriate care
                                                               to prevent and minimize episodes of moderate or severe pain.

Instructions: Generate a list of all residents who will be reviewed in the care planning meeting each week. Complete this form as you proceed through the assessment and care planning process. Enter the resident's
                                   name and check the boxes that apply for that resident. If a resident does not have pain, you do not need to answer the remaining questions for pain.

Week start date:


                                                                                                                                                                                                  In the past 5 days, the
                                                                                                           In the past 5 days, has
                                                     In the past 5 days, has    In the past 5 days, has                              In the past 5 days, has   In the past 5 days, has resident   worst pain experienced      In the past 5 days, the worst
                                                                                                          resident received non-
                                                  resident been on scheduled    resident received PRN                                 resident experienced        experienced pain "almost           on Numeric Scale          pain experienced on Verbal
         Resident Name           Stay Type                                                                       medication
                                                   pain medication regimen?           pain meds?                                        pain at any time?       constantly" or "frequently"?             (J0600A)                    Descriptor Scale
                                                                                                          interventions for pain?
                                                            (J0100A)                   (J0100B)                                              (J0300)                   (1 or 2 on J0400)           (leave blank if resident            (J0600B)
                                                                                                                  (J0100C)
                                                                                                                                                                                                      unable to answer)
                                              Advancing Excellence in America's Nursing Homes

                                            CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive
                                            appropriate care to prevent and minimize episodes of moderate or severe pain.

                                                   Weekly data summary for long stay residents.
                                                   These numbers calculate automatically - no work is required.

                                                                               Number of long-stay                               Number of long-stay
                            Number of long-stay      Number of long-stay                                Number of long-stay                                  Average of worst
       Number of long                                                        residents receiving non-                                residents who
Week                      residents on scheduled   residents receiving PRN                                 residents who                                     pain on Numeric
        stay residents                                                           medication pain                               experienced pain "almost
                         pain medication regimen      pain medications                                   experienced pain                                         Scale
                                                                                   interventions                               constantly" or "frequently"

  1           0                     0                         0                         0                        0                          0                    #DIV/0!
  2           0                     0                         0                         0                        0                          0                    #DIV/0!
  3           0                     0                         0                         0                        0                          0                    #DIV/0!
  4           0                     0                         0                         0                        0                          0                    #DIV/0!
  5           0                     0                         0                         0                        0                          0                    #DIV/0!
  6           0                     0                         0                         0                        0                          0                    #DIV/0!
  7           0                     0                         0                         0                        0                          0                    #DIV/0!
  8           0                     0                         0                         0                        0                          0                    #DIV/0!
  9           0                     0                         0                         0                        0                          0                    #DIV/0!
 10           0                     0                         0                         0                        0                          0                    #DIV/0!
 11           0                     0                         0                         0                        0                          0                    #DIV/0!
 12           0                     0                         0                         0                        0                          0                    #DIV/0!




                                                   Weekly data summary for short stay residents.
                                                   These numbers calculate automatically - no work is required.

                                                                               Number of short-stay                              Number of short-stay
                           Number of short-stay     Number of short-stay                                Number of short-stay                                 Average of worst
       Number of short                                                       residents receiving non-                                residents who
Week                      residents on scheduled   residents receiving PRN                                 residents who                                     pain on Numeric
        stay residents                                                           medication pain                               experienced pain "almost
                         pain medication regimen      pain medications                                   experienced pain                                         Scale
                                                                                   interventions                               constantly" or "frequently"

  1           0                     0                         0                         0                        0                          0                    #DIV/0!
  2           0                     0                         0                         0                        0                          0                    #DIV/0!
  3           0                     0                         0                         0                        0                          0                    #DIV/0!
  4           0                     0                         0                         0                        0                          0                    #DIV/0!
  5           0                     0                         0                         0                        0                          0                    #DIV/0!
  6           0                     0                         0                         0                        0                          0                    #DIV/0!
  7           0                     0                         0                         0                        0                          0                    #DIV/0!
  8           0                     0                         0                         0                        0                          0                    #DIV/0!
  9           0                     0                         0                         0                        0                          0                    #DIV/0!
 10           0                     0                         0                         0                        0                          0                    #DIV/0!
 11           0                     0                         0                         0                        0                          0                    #DIV/0!
 12           0                     0                         0                         0                        0                          0                    #DIV/0!
                                                                     Advancing Excellence in America's Nursing Homes

                                                                     Summary of Residents Experiencing Pain

                                                             CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive
                                                             appropriate care to prevent and minimize episodes of moderate or severe pain.



                                                                           Long Stay Residents
                                                                              Pain Management
                           100.0


                            90.0


                            80.0


                            70.0
Percent of Residents (%)




                            60.0


                            50.0


                            40.0


                            30.0


                            20.0


                            10.0


                             0.0
                                          2
                                   1 Scheduled pain3meds 4     5     6         7
                                                                              PRN pain 8
                                                                                       meds   9    10     11    12   Non-medication pain interventions
                                    Experienced pain                     Week "almost constant" or "frequent"
                                                                             Pain
                                                                      Short Stay Residents
                                                                          Pain Management
                           100.0


                            90.0


                            80.0


                            70.0
Percent of Residents (%)




                            60.0


                            50.0


                            40.0


                            30.0


                            20.0


                            10.0


                             0.0
                                          2
                                   1 Scheduled pain3meds 4   5   6        PRN pain 8
                                                                           7       meds   9    10      11   12 Non-medication pain interventions

                                    Experienced pain                 Week "almost constant" or "frequent"
                                                                        Pain
                                                                                                 Long Stay Residents
                                                                                  Frequency of Response Type on Verbal Descriptor Scale
                                                                                                          and
                                                        1                                Average of Worst Pain on Numeric Scale                                                 10.0
Frequency of Response Type on Verbal Descriptor Scale




                                                                                                                                                                                9.0




                                                                                                                                                                                       Average of Worst Pain on Numeric Scale
                                                                                                                                                                                8.0

                                                                                                                                                                                7.0

                                                                                                                                                                                6.0

                                                                                                                                                                                5.0

                                                                                                                                                                                4.0

                                                                                                                                                                                3.0

                                                                                                                                                                                2.0

                                                                                                                                                                                1.0

                                                        0                                                                                                                       0.0
                                                            1      2         3     4         5          6            7        8         9        10         11         12
                                                                                                              Week


                                                            mild       moderate     severe         horrible          unable to answer       Average of worst pain on Numeric Scale
                                                                                             Short Stay Residents
                                                                                  Frequency of Response Typeon Verbal Descriptor Scale
                                                                                                          and
                                                        1                               Average of Worst Pain on Numeric Scale                                                10.0
Frequency of Response Type on Verbal Descriptor Scale




                                                                                                                                                                              9.0




                                                                                                                                                                                     Average of Worst Pain on Numeric Scale
                                                                                                                                                                              8.0

                                                                                                                                                                              7.0

                                                                                                                                                                              6.0

                                                                                                                                                                              5.0

                                                                                                                                                                              4.0

                                                                                                                                                                              3.0

                                                                                                                                                                              2.0

                                                                                                                                                                              1.0

                                                        0                                                                                                                     0.0
                                                            1      2         3     4         5        6            7         8        9        10         11         12
                                                                                                            Week


                                                            mild       moderate     severe       horrible          unable to answer       Average of worst pain on Numeric Scale
                                                           Advancing Excellence in America's Nursing Homes

                                                                    Summary of Residents Experiencing Pain

                                                CAMPAIGN GOAL #5: Long-stay and short-stay nursing home residents will receive
                                                appropriate care to prevent and minimize episodes of moderate or severe pain.


 Changes that were made in your nursing home can be documented here. This includes any system or process changes that may have had an impact on your
             performance rates in pain, pressure ulcers, or ADLs. Include the date when the change was made and a description of the change.
Date of Change                                                            Description of Change

				
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