Joint Commission Addresses Non-pharmacologic and Non-opioid Solutions for Pain Management

PUBLISHED: Aug 30, 2018
Relevant to: Critical Access Hospitals, Hospitals

The Joint Commission (TJC) has released Quick Safety Issue 44 which addresses non-pharmacologic and non-opioid solutions for pain management. Health care organizations across the country, responding to the opioid abuse epidemic, are re-evaluating their pain management strategies, including incorporation of non-pharmacologic, non-opioid treatment options. Further, Joint Commission’s Leadership standard, LD.04.03.13, which became effective January 1, 2018, requires hospitals to identify pain assessment and management as an organizational priority, including non-pharmacologic pain treatment options.

Quick Safety Issue #44 provides a summary of evidence-based, non-opioid treatment options that health care providers might consider incorporating into pain management treatment plans.

Some of the non-pharmacologic, non-opioid treatment options reviewed include:

  • Behavioral/Cognitive Interventions/Psychological: meditation, mindfulness-based stress reduction, progressive muscle relaxation.
  • Environmental-based Interventions: lighting, music therapy.
  • Physical Interventions: acupuncture, acupressure, massage therapy, spinal manipulation
  • Non-opioid pharmacologic interventions: non-steroidal anti-inflammatory agents (NSAIDs), acetaminophen, corticosteroids other topical products.

Regardless of the intervention used, TJC encourages health care organizations to be sure clinicians are provided with information, support and the following safety actions are considered:

  • Evaluation of non-pharmacologic and non-opioid solutions should include:
    • Population(s) served by the organization
    • Source of individuals pain
    • A system for treating patient pain including:
    • Multidisciplinary team participation, including at minimum medical staff, nurses and pharmacists.
    • Comprehensive evaluation and development of treatment plan that incorporates realistic goals and a balance of pharmacological and non-pharmacological treatments.
    • Monitoring of patient’s pain management including assessment of side effects, signs and symptoms of opiate abuse and ensuring treatment goals are met.
    • Process for determining when non-invasive options are not working and/or when referral is needed for additional treatment options.
    • Training and education for healthcare team on non-pharmacologic and non-opioid solution modalities
    • Education for patients and families on pain management modalities selected including specific goals: anticipated pain relief, treatment frequency, potential side effects.

Included with today’s notice is a link to TJC’s Quick Safety Issue and example policies and procedures related to a comprehensive pain management program.

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