Appropriate pain management is a critical component
of geriatric trauma care. Cognitive impairment, fear of addition,
fear of adverse side effects, and sensory impairment
can all lead to inadequate pain control in this population.
At LVHN, it was discovered that residents were
often unaware of the unique needs of the geriatric trauma
population, which can lead to inappropriate medication
orders for pain. The NICHE nurses also identified a need
for a resource guiding appropriate pain, agitation, and
sleep medications recommended for the geriatric patient.
A Pain Medication Recommendation and Agitation/Sleep
Recommendation list was developed as a resource for
nurses. This list provides appropriate geriatric pain, agitation,
and sleep medication doses and frequencies to decrease
adverse outcomes associated with inappropriate
orders. This list was created by our trauma team by partnering
with our geriatricians to include geriatric concepts
of pain control, such as low-dose opioids, around-theclock
analgesics when appropriate, dosing guidelines,
nonpharmacological pain interventions, and a list of
medications contraindicated in the elderly for pain, agitation,
and sleep for avoidance of inappropriate medication
orders