Mapping cancer pain screening, assessment and reassessment practices within one Australian health district: results from a baseline chart audit (#231)
Despite, people receiving cancer treatment being in frequent contact with health professionals, some 30–75% experience cancer related pain, which is frequently undertreated. International cancer pain guidelines recommend routine: screening, obtaining patient reported pain scores, completing a comprehensive pain assessment and reassessment. Yet, the degree to which these practices are embedded into routine inpatient cancer care in Australia is largely unknown.
To determine the level of pain screening, assessment and re-assessment practices within four public hospitals, including a specialist gynecological oncology service within one health district in NSW, Australia.
Consecutive chart audits of all inpatients with a cancer related admission of ≥ 3 days during a one month audit period and who experienced pain on or during this admission.
Of the 92 inpatients that met the inclusion criteria, the majority were female (58%), median age 65.1 years (SD + 12.4), with lung cancer (17%) and a mean inpatient stay of 8.3 days (SD + 6.2). A third (33%) had been admitted specifically for pain control. On admission, 86% were screened for pain, with a pain score documented for 34% on or during their admission. Very few (3%) had a comprehensive pain assessment documented. There was no evidence of a standardized pain assessment tool being used, with patients’ reports of pain documented in a variety of locations.
This chart audit data suggests there are opportunities to improve pain screening, assessment and reassessment practice across these inpatient cancer care units by focusing on: patient, provider and system level factors.