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«October 2000 Revised Edition Geriatrics and Extended Care Strategic Healthcare Group National Pain Management Coordinating Committee Veterans Health ...»

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Care of Patients Chapter (TX) - Introduction to Rehabilitation Care and Services Standards, Intents, and Examples for Rehabilitation Care and Services (Introduction to standards TX.6 thru TX.6.4):

Rehabilitation is designed to achieve an optimal level of functioning, self-care, selfresponsibility, independence, and quality of life. Achieving the patient's optimal level of functioning means restoring, improving, or maintaining the patient's assessed level of functioning. Rehabilitation services aim to minimize symptoms, exacerbation of chronic illnesses, impairments, and disabilities.

Qualified professionals provide rehabilitation services consistent with professional standards of practice. All interventions encourage the patient to make choices, to sustain a sense of achievement about treatment progress, and if necessary, to modify participation in the rehabilitation process.

Assessment identifies the patient's physical, cognitive, behavioral, communicative, emotional, and social status and identifies facilitating factors that may influence attainment of rehabilitation goals. Problems may include

• substance use disorders;

• emotional, behavioral, and mental disorders;

• cognitive disorders;

• developmental disabilities;

• vision and hearing impairments and disabilities;

• physical impairments and disabilities; and

• pain interfering with optimal level of function or participation in rehabilitation.


Pain as the 5th Vital Sign Toolkit Page 54 Education Chapter (PF) - Standard PF.1.7 and Intent PF.1 The patient's learning needs, abilities, preferences, and readiness to learn are assessed.

PF.1.7 Patients are taught that pain management is an essential part of treatment.

Intent of PF.1 Through PF.1.9 Hospitals offer education to patients and families to give them the specific knowledge and skills they need to meet the patient's ongoing health needs. Clearly, such instruction needs to be presented in ways that are understandable to those receiving them.

Openness and flexibility are important elements in patient education, and can make a critical difference in whether the patient follows the instructions. In assessing a patient's needs, abilities,

and readiness for education, staff members take into account such variables as:

• The patient's and family's beliefs and values;

• Their literacy, education level, and language;

• Emotional barriers and motivations;

• Physical and cognitive limitations

• The financial implications of care choices … In addition, the hospital uses guidelines in

educating patients on the following topics:

• Safe and effective use of medications;

• Safe and effective use of medical equipment;

• Diet and nutrition;

• Understanding pain and the importance of effective pain management;

• Rehabilitation;

• Educational resources in the community; and

• Follow-up care.

The appropriate disciplines are involved in developing these guidelines.

Continuum of Care and Services Chapter (CC) - Intent for Standard CC.6.1 CC.6.1. The discharge process for continuing care based upon the patient's assessed needs at the time of discharge.

Intent of CC.6.1 Discharge planning focuses on meeting the patient's health care needs after discharge. Discharge planning identifies patients' continuing physical, emotional, symptom management (e.g. pain, ______________________________________________________________________________________________

Pain as the 5th Vital Sign Toolkit Page 55 nausea, or dyspnea), housekeeping, transportation, social, and other needs, and arranges for services to meet them.

Improving Organization Performance Chapter (PI) - Intent for Standards PI.3.1 PI.3.1 The organization collects data to monitor its performance.

Intent of PI.3.1 Performance monitoring and improvement are data driven. The stability of important processes can provide the organization with information about its performance. Every organization must choose which processes and outcomes (and thus types of data) are important to monitor based on its mission and the scope of care and services provided. The leaders prioritize data collection based on the organizations mission, car and services provided, and populations served (refer to LD.0.00 for priority setting). Data which the organization considers for collection to monitor

performance include:

• Performance measures related to accreditation and other requirements;

• Risk management;

• Utilization management;

• Quality control;

• Staff opinions and needs;

• If used, behavior management procedures;

• Outcomes of processes or services;

• Autopsy results, when performed;

• Performance measures from acceptable databases;

• Customer demographics and diagnoses;

• Financial data;

• Infection control surveillance and reporting;

• Research data;

• Performance data identified in various chapters in this Manual; and

• The appropriateness and effectiveness of pain management.

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