GOLDAGE-PANACEA Outcome measures (Pre-training)

PANACEA facilitators to answer questions 2 - 6

A sample size of 5 RNs/EENs/Cert IVs and 10 carers to complete this survey as per instructions below:

All staff to answer questions 7 - 11

RNs/EENs/Cert IVs to answer questions 13 - 20
Name: 


A red asterisk (*) indicates required questions.

  1. (All staff) Facility:*


  1. (PANACEA facilitators only) Number of residents in the facility/your community ?


  1. (PANACEA facilitators only) Number of residents receiving CHC 3 – Pain management involving therapeutic massage or application of heat packs by care staff.


  1. (PANACEA facilitators only) Number of residents receiving CHC 4a – Pain management involving therapeutic massage or use of pain management equipment by RN.


  1. (PANACEA facilitators only) Number of residents receiving CHC 4b – Pain management involving therapeutic massage or use of pain management equipment by allied health professional 4 times a week.


  1. (PANACEA facilitators only) Number of residents receiving pharmacological interventions for chronic pain.


  1. (All staff) Position  *


  1. (All staff) In the past week, how many residents have you identified as having previously unrecognised pain?


  1. (All staff) For these residents, how many were identified through:
    (If nil, leave blank)

            1 2 3 4 5 6 7 8 9 10      
      Resident report of pain  1 10  
      Family report of pain 1 10  
      A change in behaviour  1 10  
      Observation during care activities 1 10  
      Pain assessment  1 10  


  1. (All staff) In the past week, how many different residents have you talked to about their pain.


  1. (All staff) In the past week, for how many residents have you had a conversation about their pain:
    (If 0 conversations in any category, leave blank)

            1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20      
      With the resident's family 1 20  
      With other staff 1 20  
      With the resident's GP (RNs/EENs/Cert IVs only) 1 20  


  1. (Carers only) How many pain assessments have you completed in the past week?


  1. (RNs/EENs/Cert IVs only) How many pain management interventions have you initiated/reviewed in the past week (either non-pharmacological or pharmacological)?


  1. (RNs/EENs/Cert IVs only) In the past week, how many residents have you conducted a formal comprehensive pain assessment on (e.g. using the MRVBPI, Abbey, PAINAD, NOPPAIN)?


  1. (RNs/EENs/Cert IVs only) In the past week, how many residents have you identified as having a new source of chronic pain or chronic pain that was sub-optimally controlled?


  1. (RNs/EENs/Cert IVs only) Of these residents, how many have had a change made to their pain management?
    (If nil, leave blank)

            1 2 3 4 5 6 7 8 9 10      
      Change in medications 1 10  
      Change in non-pharmacological therapy 1 10  


  1. (RNs/EENs/Cert IVs only) In the past month, how many new residents have entered your facility?


  1. (RNs/EENs/Cert IVs only) In the past month, how many of these new residents have you conducted a formal comprehensive pain assessment on (e.g. using the MRVBPI, Abbey, PAINAD, NOPPAIN)?


  1. (RNs/EENs/Cert IVs only) In the past month, how many of these new residents have you identified as having chronic pain that was sub-optimally controlled?


  1. (RNs/EENs/Cert IVs only) Of these residents, how many have had a change made to their pain management?
    (If nil, leave blank)

            1 2 3 4 5 6 7 8 9 10      
      Change in medications 1 10  
      Change in non-pharmacological therapy 1 10  





Judith McIvor