(110) Disparities in pain assessment: using data to understand associations with language proficiency and developmental age

Abstract

Comprehensive pain assessment invokes methods that are reliable and valid, including measures of pain intensity that are developmentally appropriate and clinically sensitive enough to detect changes in pain state. The degree to which children’s or parents’ language proficiency impacts the quality and quantity of pain assessment has been reported.1 Data published from our institution had shown that limited English proficiency (LEP) negatively affected the frequency of pain assessment and associated impact on analgesic delivery, despite results also showing higher pain intensity scores in children with LEP. The primary objective of this work was to implement a monitoring plan to assess the association between pain assessment and LEP and developmental age. An interdisciplinary team identified the parameters and developed a data monitoring plan for variables pertaining to pain assessment documentation. Data flow from the electronic medical record (EMR) to a real-time dashboard report. The sample may be viewed by trends over an extended period of time, as well as in specific historical epochs pre- and post-interventions, depending on the specific question. Data illustrating the association between pain assessment and patient variables of LEP and developmental age will be presented. Specifically, English proficiency will be correlated with (a) the use of observational pain intensity scales in children rather than self-report, and (b) the frequency of pain assessments. With a premium on eliminating disparity, this work demonstrates data monitoring to inform targeted intervention or further qualitative study to understand the experience and any barriers at the bedside. (1. Jimenez, Hosp Pediatrics, 2014.)