Quality Pain Management in Adult Hospitalized Patients: A Concept Evaluation

Aim To explore the concept of quality pain management (QPM) in adult hospitalized patients. Background Pain is common in hospitalized patients, and pain management remains suboptimal in some settings. Design A concept evaluation based on Morse et al.'s method. Data Source Of more than 5,000 articles found, data were restricted to 37 selected key articles published in peer-reviewed journals. Review Methods Data were extracted from the selected articles and then synthesized according to the following: definition, characteristics, boundaries, preconditions, and outcomes. Results QPM relates to the Structure: organizationally supported evidence-based policies, competent staff, interprofessional and specialized care, and staff accountability; Process: screening, assessment/reassessment and communication of pain and its treatment, patient/family education, individualized evidence-based treatment, embedded in safe, effective, patient-centered, timely, efficient, and equitable services; and Outcomes: reduced pain severity and functional interference, decreased prevalence/severity of adverse consequences from pain or pain treatment, and increase in patient satisfaction. Conclusions QPM is a multifaceted concept that remains poorly defined in the literature. Studies should aim to develop valid, reliable, and operational measures of the pillars of QPM and to look at the relationship among these factors. Authors need to state how they define and what aspects of QPM they are measuring.