Mapping cancer pain screening, assessment and reassessment practices within one Australian health district: results from a baseline chart audit

Mapping cancer pain screening, assessment and reassessment practices within one Australian health district: results from a baseline chart audit

Introduction: 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.

Aim: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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