technology
What insights have surprised you about PainChek?
One of the things we’ve gleaned from this whole process is that
it helps carers identify the presence of pain when it isn’t obvious,
and it helps them quantify the severity of pain when it is obvious.
Also, we’ve introduced a facility to monitor the effectiveness of
intervention. So it’s a little bit like a thermometer: you may know
somebody has a fever, but you don’t know what the fever level is.
The thermometer gives you the ability to identify the temperature
and see how the therapy impacts on reducing it. PainChek is the
same: it assesses the quantity of pain, and then, with the builtin
monitoring capability, it shows how you’re affecting that pain
through treatment.
BETTER PAIN CARE
Barossa Village in South Australia houses 100 residents and has
been using PainChek since November. Aged Care Insite spoke
with general manager Matt Kowald about the app and asked how
it had changed the way they assess pain. Kowald said the tool
had altered the way the centre assessed pain and enabled staff to
provide better pain care to the residents.
“The automatic reporting feature has improved the efficiency
of data handling, and simplified reporting for accreditation and
auditing purposes,” he said.
Kowald said it refocuses people to show that pain is a factor
for behaviour. He also pointed out the added benefits for non-
users, saying that families like it as it supports someone who is
non-verbal.
“It’s nice to put a number on pain. It’s like taking your blood
pressure: you have a number that’s measurable,” he said.
It’s actually taken the spotlight away from pain and gone, “Right,
well, let’s have a look at this holistically and say this behaviour
could be related to the pain.” So it’s been as much about managing
behaviours of concern in people with dementia as opposed to
managing pain. It’s a bit of both.
What differences has the tool has brought to the identification
of pain management?
Again, it’s made it first and foremost in people’s minds. Any time
you introduce something new, it reinvigorates the thinking around
it. Also, with younger staff there’s that, “Oh, technology I’m going
to grasp hold of it and use it.” So it’s given people something else
to hold on to around managing pain and looking at behaviours.
I think it’s just raised the profile. It’s taken it from something that
is difficult to quantify to something where carers can say, “I’ve got
some hard evidence around this, and I can present it to my GP or
my geriatrician to say that this is the problem and this is how we
need to manage it.” So it gives the nursing staff more power, which
makes for better clinical decision-making. ■
ACI: Matt, as a provider, why did you decide to implement this
product into the village?
MK: Actually, it was a simple choice in the end. I saw the
demonstration by Dementia Support Australia when they came
to see a resident here in November. It was really quite compelling
that a resident we were looking at all the time was exhibiting
behaviours that we had put down to their managing dementia,
and it really came down to pain. And then after seeing that
demonstration, it was like, well, if you’ve got a memory support
unit and you’re dealing with people that are non-verbal, it’s difficult
not to have that tool in your arsenal.
How have residents reacted to this introduction?
The residents are quite used to technology here. We often use
iPads for consultations with medical staff, and the residents see
us using iPads with them on a regular basis. So even people that
have advanced dementia don’t seem to mind seeing their face
on a screen, which is essentially what happens most of the time.
And families – which are probably the quality control measure in
this case – love the fact that we’re investing in a technology that
supports people who aren’t able to verbalise their pain.
How has this impacted the nursing staff?
I was lucky enough to spend some time with Jennifer Abbey a while
back. The Abbey pain score is what we’ve been using for a long
time. With many pain scores, people tend to just tick the boxes,
whereas PainChek tends to make people go through the system.
You actually have to stop and spend time with the resident. I keep
saying it’s like using a blood pressure machine. You actually have to
put it on and go through a process, and you can’t not go through
one part of that process. So it makes people systematic.
PainChek is approved by Dementia Training Australia. Based on the Abbey
pain scale, it recognises the benign micro facial expressions that indicate pain.
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