Documented local arrangements that include a written clinical protocol to ensure patients with hip fracture receive prompt and effective pain management. The protocol should:

• Take account of the hierarchy of pain management medicine that should be considered for managing pain associated with hip fracture, aiming to minimise the use of opioid medicine.

• Include prescribed intervals for assessment of pain amongst hip fracture patients, as follows:
  • immediately upon presentation to hospital, and
  • within 30 minutes of administering initial analgesia, and
  • hourly until settled on the ward, and
  • regularly as part of routine nursing and other clinicians’ observations throughout admission.

• Include the use of a standardised pain assessment system, which specifically addresses the assessment of pain for patients with cognitive impairment and those unable to communicate pain, particularly with regard to minimising the use of opioid medicine in this group.

Yes/No

Yes/No

Macintyre PE, Scott DA, Schug SA, Visser EJ, Walker SM; Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine 2010. Acute Pain Management: Scientific Evidence 3rd edn, Melbourne: ANZCA & FPM.