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¶ … Best Practices for the Pain Management of Broken Hips
Achieving the Institute of Medicine's goal of ensuring that 90% of health care decisions are evidence-based by 2020 will require identifying current gaps between research, findings, and practice implementation. One practice identified in the Agency for Healthcare Research and Quality (AHRQ) comparative effectiveness research site concerns pain management for broken hips. This paper examines a gap that currently exists between research findings and the implication of those findings in this practice, followed by a summary of the research in the conclusion.
Discussion of the practice
Although anyone can break a hip, broken hips are more common among the elderly and can be caused by a fall or simply by the weakening of the femur with age (Managing pain from a broken hip, 2011). For instance, the AHRQ reports that, "[The incidence] of hip fractures increases substantially with age, rising for men and women, respectively, from 22.5 and 23.9 per 100,000 populations at age 50, to 630.2 and 1,289.3 per 100,000 populations by age 80" (Pain management interventions for hip fracture, 2011, p. 1). Without effective pain management, though, people, especially the elderly, who suffer a broken hip can experience delirium, sleep disruption and depression. In addition, ineffective pain management for broken hips...
Although a number of pharmacological interventions are available to ensure effective pain management for people with broken hips, clinicians may not fully realize the severity of the pain that is involved as discussed further below.
Assessment concerning the extent to which the practice is being implemented
While a number of pain management options are available for patients suffering from severe pain, many clinicians fail to provide adequate pain management therapy (Moore & Anderson, 2016). The Joint Commission promulgated pain management standards in 2001 in response to the ubiquitous problem of poor pain management practices (Baker, 2017). According to Baker, "The Joint Commission's current standards require that organizations establish policies regarding pain assessment and treatment and conduct educational efforts to ensure compliance" (2017, para. 2). These standards, however, are not being followed in far too many cases for the reasons discussed below.
Evaluation of the barriers to implementation into practice
There are several reasons for the failure of clinicians to follow pain management guidelines, including (a) organizational and administrative barriers to providing effective care; (b) inadequate or limited training…
References
Baker, D. W. (2017). Joint Commission statement on pain management. Joint Commission. Retrieved from https://www.jointcommission.org/joint_commission_statement_on_ pain_management/.
Managing pain from a broken hip. (2011). Agency for Healthcare Research and Quality. Retrieved from https://effectivehealthcare.ahrq.gov/ehc/products/95/677/Hip Fracture_Consumer_20110517.pdf.
Moore, B. A. & Anderson, D. (2016, January). Stepped care model for pain management and quality of pain care in long-term opioid therapy. Journal of Rehabilitation Research & Development, 53(1), 137-140.
Pain management interventions for hip fracture. (2011). Agency for Healthcare Research and Quality. Retrieved from https://effectivehealthcare.ahrq.gov/ehc/products/95/67 6/CER30_executivesummary_20110517.pdf.
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