Pain Management - Screening versus Assessment - PC.01.02.07 EP 1

What is the difference between “screening” vs “assessing” pain and what is the expectation?

Any examples are for illustrative purposes only.

A ‘screening’ is a process for evaluating the possible presence of a problem.  An 'assessment' gathers more detailed information through collection of data, observation, and physical examination. Assessments are completed by individuals deemed qualified through education, training, licensure, etc., to conduct such evaluations. Pain assessment tools are generally evidence-based and often include, at a minimum, an evaluation of pain intensity, location, quality, and associated symptoms. An accurate pain screening and assessment is the foundation on which an individualized, effective pain management plan is developed.

For example, a pain 'screening' may be used to determine if the patient has pain or not. If the patient answers “yes”, a comprehensive pain assessment would be indicated.  If the patient answers “no” no further pain assessment would be expected, unless required by organizational policy.

Organizations are responsible for ensuring that appropriate screening and assessment tools are readily available and used appropriately. The tools required to adequately assess pain may differ depending on a patient’s age, condition, and ability to understand, and whether pain is acute or chronic. For example, for an episode of acute pain from an identified cause, brief assessment of pain intensity and characteristics may be sufficient.

Chronic pain generally requires more extensive patient assessment, including various domains of physical and functional impairment. Reassessment is conducted as necessary based on the patient’s plan of care or changes in his or her condition. The timeframe for reassessment should be determined by the patient’s condition and goals of treatment. For example, pain from a minor injury may be relieved within minutes or hours of treatment. By contrast, improvement in chronic pain is unlikely to be observed during a similar timeframe. Among patients with chronic pain, reassessment should focus on whether a treatment improves the patient’s physical and psychosocial function based on the discussed realistic expectations for the duration of pain (See PC.01.02.07 EP 5).

Resources:
R3 Report: Pain assessment and management standards for Hospitals
R3 Report: Pain assessment and management standards for Critical Access Hospitals
R3 Report: Pain assessment and management standards for Ambulatory Care
R3 Report: Pain assessment and management standards for Office-based Surgery
Sentinel Event Alert Issue 49: Safe use of opioids in hospitals
 

 
Last updated on June 29, 2020
Manual: Ambulatory
Chapter: Provision of Care Treatment and Services PC

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