Pain Management Audit Pain Management Audit

Hospital ggg
Ward/Dept ABC
Auditor(s) (insert name(s) and title(s))
Date of Audit 12/12/2014
No. in Audit 3

Instruction: Example: Click on cells to access drop down list of possible answers. Please enter total
no of patients included in audit in to yellow box to enable automatic calculation of results. Additional
questions may be added to this tool. Use format dd/mm/yy for dates and hh:mm in 24 hour clock for
times calculation of results. Do not include people with mild pain

A1 Audit Number 1 2 3 4 5
A2 ED Card Number
A3 Date of Arrival at ED 12/10/14 Missing
A4 Time of Arrival at ED 10:10

A5 Was analgesia administered pre hospital No

A6 Pain score on arrival to ED

A7 Was analgesia administered or offered in ED Yes Yes No Yes Yes

No reason
A8 Reason why analgesia not offered in ED? identified

A9 Date at which analgesia administered or offered in ED 12/10/14 12/10/14 12/10/14 12/10/14 12/10/14

A10 Time at which analgesia administered or offered in ED 10:20 10:50 10:20 10:50 10:20
A11 Was ED analgesia accepted?

A12 Was ED analgesia in accordance with local guidelines?

A13 If a child were they weighed?

A14 Is there documented evidence of re-evaluation of analgesia effect in the ED?

A15 Date at which analgesia re-evaluated in the ED? 12/10/14 12/10/14

A16 Time at which analgesia re-evaluated in the ED? 10:55 11:50

 Pain Management Audit Pain Management Audit
Hospital ggg
Ward/Dept ABC
Auditor(s) (insert name(s) and title(s))
Date of Audit 12/12/2014
No. in Audit 3

Instruction: Example: Click on cells to access drop down list of possible answers. Please enter total
no of patients included in audit in to yellow box to enable automatic calculation of results. Additional
questions may be added to this tool. Use format dd/mm/yy for dates and hh:mm in 24 hour clock for
times calculation of results. Do not include people with mild pain

A1 Audit Number 1 2 3 4 5
A2 ED Card Number

Date & Time of Arrival at ED 10/12/2014 10:10 #VALUE! 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00

Date & Time at which analgesia administered or offered in ED 10/12/2014 10:20 10/12/2014 10:50 10/12/2014 10:20 10/12/2014 10:50 10/12/2014 10:20

Date & Time at which analgesia re-evaluated in the ED? 10/12/2014 10:55 10/12/2014 11:50 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00

Time from arrival to time of analgesia 0:10 #VALUE! 10:20 10:50 10:20

Time from hospital analgesia to re-evaluation 0:34 1:00 13:40 13:10 13:40
analgesia analgesia analgesia analgesia
If no analgesia given was there a documented reason as to why no anlangesia administerd or administerd or No documented administerd or administerd or
given reason given reason given reason reason given reason given
 Pain Management Audit Pain Management Audit
Hospital ggg
Ward/Dept ABC
Auditor(s) (insert name(s) and title(s))
Date of Audit 12/12/2014
No. in Audit 3

A1 Audit Number 6 7 8 9 10
A2 ED Card Number
A3 Date of Arrival at ED
A4 Time of Arrival at ED

A5 Was analgesia administered pre hospital

A6 Pain score on arrival to ED

A7 Was analgesia administered or offered in ED No Yes Yes Yes Yes

A8 Reason why analgesia not offered in ED?

A9 Date at which analgesia administered or offered in ED 12/10/14 12/10/14 12/10/14 12/10/14 12/10/14

A10 Time at which analgesia administered or offered in ED 10:50 10:20 10:50 10:20 10:50
A11 Was ED analgesia accepted?

A12 Was ED analgesia in accordance with local guidelines?

A13 If a child were they weighed?

A14 Is there documented evidence of re-evaluation of analgesia effect in the ED?

A15 Date at which analgesia re-evaluated in the ED?

A16 Time at which analgesia re-evaluated in the ED?

 Pain Management Audit Pain Management Audit
Hospital ggg
Ward/Dept ABC
Auditor(s) (insert name(s) and title(s))
Date of Audit 12/12/2014
No. in Audit 3

A1 Audit Number 6 7 8 9 10
A2 ED Card Number

Date & Time of Arrival at ED 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00

Date & Time at which analgesia administered or offered in ED 10/12/2014 10:50 10/12/2014 10:20 10/12/2014 10:50 10/12/2014 10:20 10/12/2014 10:50

Date & Time at which analgesia re-evaluated in the ED? 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00

Time from arrival to time of analgesia 10:50 10:20 10:50 10:20 10:50

Time from hospital analgesia to re-evaluation 13:10 13:40 13:10 13:40 13:10
analgesia analgesia analgesia analgesia analgesia
If no analgesia given was there a documented reason as to why no anlangesia administerd or administerd or administerd or administerd or administerd or
given reason given reason given reason given reason given reason given
 Pain Management Audit Pain Management Audit
Hospital ggg
Ward/Dept ABC
Auditor(s) (insert name(s) and title(s))
Date of Audit 12/12/2014
No. in Audit 3

A1 Audit Number 11 12 13 14 15
A2 ED Card Number
A3 Date of Arrival at ED
A4 Time of Arrival at ED

A5 Was analgesia administered pre hospital

A6 Pain score on arrival to ED

A7 Was analgesia administered or offered in ED Yes Yes Yes Yes Yes

A8 Reason why analgesia not offered in ED?

A9 Date at which analgesia administered or offered in ED 12/10/14 12/10/14 12/10/14 12/10/14 12/10/14

A10 Time at which analgesia administered or offered in ED 10:20 10:50 10:20 10:50 10:20
A11 Was ED analgesia accepted?

A12 Was ED analgesia in accordance with local guidelines?

A13 If a child were they weighed?

A14 Is there documented evidence of re-evaluation of analgesia effect in the ED?

A15 Date at which analgesia re-evaluated in the ED?

A16 Time at which analgesia re-evaluated in the ED?

 Pain Management Audit Pain Management Audit
Hospital ggg
Ward/Dept ABC
Auditor(s) (insert name(s) and title(s))
Date of Audit 12/12/2014
No. in Audit 3

A1 Audit Number 11 12 13 14 15
A2 ED Card Number

Date & Time of Arrival at ED 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00

Date & Time at which analgesia administered or offered in ED 10/12/2014 10:20 10/12/2014 10:50 10/12/2014 10:20 10/12/2014 10:50 10/12/2014 10:20

Date & Time at which analgesia re-evaluated in the ED? 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00

Time from arrival to time of analgesia 10:20 10:50 10:20 10:50 10:20

Time from hospital analgesia to re-evaluation 13:40 13:10 13:40 13:10 13:40
analgesia analgesia analgesia analgesia analgesia
If no analgesia given was there a documented reason as to why no anlangesia administerd or administerd or administerd or administerd or administerd or
given reason given reason given reason given reason given reason given
 Pain Management Audit
Hospital
Ward/Dept
Auditor(s)
Date of Audit
No. in Audit

A1 Audit Number 16 17 18 19 20
A2 ED Card Number
A3 Date of Arrival at ED
A4 Time of Arrival at ED

A5 Was analgesia administered pre hospital

A6 Pain score on arrival to ED

A7 Was analgesia administered or offered in ED Yes Yes Yes Yes Yes

A8 Reason why analgesia not offered in ED?

A9 Date at which analgesia administered or offered in ED 12/10/14 12/10/14 12/10/14 12/10/14 12/10/14

A10 Time at which analgesia administered or offered in ED 10:50 10:20 10:50 10:20 10:50
A11 Was ED analgesia accepted?

A12 Was ED analgesia in accordance with local guidelines?

A13 If a child were they weighed?

A14 Is there documented evidence of re-evaluation of analgesia effect in the ED?

A15 Date at which analgesia re-evaluated in the ED?

A16 Time at which analgesia re-evaluated in the ED?

 Pain Management Audit
Hospital
Ward/Dept
Auditor(s)
Date of Audit
No. in Audit

A1 Audit Number 16 17 18 19 20
A2 ED Card Number

Date & Time of Arrival at ED 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00

Date & Time at which analgesia administered or offered in ED 10/12/2014 10:50 10/12/2014 10:20 10/12/2014 10:50 10/12/2014 10:20 10/12/2014 10:50

Date & Time at which analgesia re-evaluated in the ED? 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00 12/30/1899 0:00

Time from arrival to time of analgesia 10:50 10:20 10:50 10:20 10:50

Time from hospital analgesia to re-evaluation 13:10 13:40 13:10 13:40 13:10
analgesia analgesia analgesia analgesia analgesia
If no analgesia given was there a documented reason as to why no anlangesia administerd or administerd or administerd or administerd or administerd or
given reason given reason given reason given reason given reason given
 Pain Management Audit
Hospital ggg
Ward/Dept ABC
Auditor(s) (insert name(s) and title(s))
Date of Audit 12/12/2014
No. in Audit 3

Was analgesia administered pre hospital

Frequency %
Yes 0 0.0%
No 1 33.3%
Not recorded 0 0.0%
Total 1 33.3%

Pain score on arrival to ED

Frequency %
Moderate (4-6) 0 0.0%
Severe (7-10) 0 0.0%
Not recorded 0 0.0%
Total 0 0.0%

Was analgesia administered or offered in ED

Frequency %
Yes 18 600.0%
No 2 66.7%
N/A 0 0.0%
Not recorded 0 0.0%
Total 20 666.7%

Was ED analgesia accepted?

Frequency %
Yes Err:508 0.0%
No Err:508 0.0%
N/A Err:508 0.0%
Not recorded Err:508 0.0%
Total 0 0.0%
 Pain Management Audit
Hospital ggg
Ward/Dept ABC
Auditor(s) (insert name(s) and title(s))
Date of Audit 12/12/2014
No. in Audit 3

Was ED analgesia in accordance with local guidelines?

Frequency %
Yes Err:508 0.0%
No Err:508 0.0%
Partially Err:508 0.0%
N/A Err:508 0.0%
Total 0 0.0%

If a child were they weighed?

Frequency %
Yes Err:508 0.0%
No Err:508 0.0%
N/A Err:508 0.0%
Total 0 0.0%

Is there documented evidence of re-evaluation of analgesia effect in the ED?

Frequency %
Yes Err:508 0.0%
No Err:508 0.0%
Not Applicable Err:508 0.0%
Total 0 0.0%
 Pain Management Audit
Hospital ggg
Ward/Dept ABC
Auditor(s) (insert name(s) and title(s))
Date of Audit 12/12/2014
No. in Audit 3

CEM Standards

Patients in severe pain (pain score 7 to 10) or moderate pain (pain score 4 to 6) receive
appropriate analgesia, according to local guidelines or CEM pain guidelines,
a. 75% within 30min of arrival
1 b. 100% within 60min of arrival

Patients with severe pain or moderate pain – 90% should have documented evidence of re-
2 evaluation and action within 120 minutes of the first dose of analgesic
If analgesia is not prescribed and the patient has moderate or severe pain the reason should
3 be documented in the notes.

Standards Frequency % Standard Compliant

Number of patients
offered pain relief within
30 mins of arrival 1 5.6% 75% Non-Complaint

Number of patients
offered pain relief within
60 mins of arrival 1 5.6% 100% Non-Complaint

Number of patients re-

evaluated within 120
minutes of first dose of
hospital administration of
analgesia 20 111.1% 90% Compliant

No pf patients who were

not offered or
administered analgesia
who had No documented
reason why analgesia not
offered 1 5.6%
 Pain Management Audit
Hospital ggg
Ward/Dept ABC
Auditor(s) (insert name(s) and title(s))
Date of Audit 12/12/2014
No. in Audit 3

Recommendations arising from the audit: Responsibilty Date for Completion