November 13, 2000
Pain assessment now
By Alicia Lurry
Efforts to bring pain relief to sickle cell patients could be just a
touch of a pen away, thanks to advances in current technology.
James Eckman and Allan Platt, staff members at the Georgia Comprehensive
Sickle Cell Center at Grady, have designed and tested a new, multidimensional
pain assessment method that captures four dimensions of pain on a palmtop
computer in less than one minute.
With help from private industry, theyve developed the system into
a nursing process solution that allows bedside entry of all the vital
signs, intake-output, therapy given, pain assessment and patient satisfaction.
Platt, program coordinator at the Sickle Cell Center, presented and discussed
the pain assessment model at a recent Joint Commission on Accreditation
of Healthcare Organizations (JCAHO) conference in Chicago. Research for
the pain assessment method is ongoing at Grady Hospital.
Here is how the technology works: Each pain episode is recorded on a
Palm Pilot, a $150 handheld, touch-screen computer. With the use of an
electronic pen, the device records pain location, radiation, associated
symptoms, characteristics, setting, onset, duration, timing and other
More than one pain site can be documented on one patient, and each site
can be assessed multiple times, as can the severity of pain.
Using this technology, pain is assessed using four numerical analog scales:
intensity, relief, sideeffects and mood. The patient ranks the importance
of each variable on a scale of 1 to 4, with 1 being least important.
The patient is then presented with visual analog scales on the touch
screen numbered 0 to 10, and is requested to select a level for each dimension.
The Palm Pilot is programmed to time- and date-stamp the entry and store
the numerical value of the mark.
At the nursing station, staff can then transfer their Palm data to a
desktop computer. All information except the units patient room
list is removed from the Palm and stored in the personal computer immediately
after the information is gathered. Summary reports and graphs can be viewed
and/or printed in time and date order for the paper chart or at any time
the information is needed in paper form.
Triad Technologies has also designed a pain assessment centralized database
that is accessible to patients. In the future, this database will allow
patient entry of pain assessment values, via the Internet, from a touchtone
phone using interactive voice response (IVR) technology, and from handheld
Sickle cell anemia is a blood disorder characterized by hard, sticky,
sickle-shaped red blood cells. Because of the cell changes, a person can
suffer from incredible pain (most commonly in the arms, legs and back),
organ damage, infections, jaundice and anemia.