Continuously serving Kosciusko County since 1854
Luann Deafenbaugh lives with other people's pain every day.
Deafenbaugh works in the oncology department of Kosciusko Community Hospital and she's helped people deal with severe pain, shooting pain, sharp pain, burning pain and painful pain.
"We consider pain as the fifth vital sign now," Deafenbaugh said. "We've been doing it for quite a while."
KCH is accredited by the Joint Commission on Accreditation of Healthcare Organizations.
JCAHO's mission is to continuously improve the safety and quality of care provided to the public by accreditation and related services that support performance improvement in health care organizations.
KCH is regularly inspected by JCAHO staffers, who spend two or three days surveying the medical staff, hospital staff and its policies, procedures and quality of care. They decide whether or not to accredit a facility.
JCAHO also sets standards and makes recommendations to its members. A recent standard is a patient's right to pain management.
Deafenbaugh heads the KCH Continuous Quality Improvement team on pain management. She is also program coordinator in oncology for cancer services.
The team, made up of physicians, nurses and a chaplain, has been addressing pain management all along and always believed they could do more.
"Patient surveys were returned showing we were doing an OK job with pain control," she said. "Other studies would show there were a lot of people not getting their pain taken care of. Our scores may have been high as far as a patient's satisfaction was concerned. It didn't reflect what they needed."
To aid in pain assessment the hospital nursing staff now asks very direct questions about pain.
"Midwesterners are very stoic about pain," she said.
In other words, they often don't ask for the pain relief they could have.
Patients are asked to rate pain using a scale numbered from zero to 10, with 10 the most painful.
"We've always used a scale of some kind in the different departments," Deafenbaugh said.
In one department a zero-to-10 scale would be used, while Home Health Care would use one numbered from zero-to-five.
"If a home health care patient, used to the zero-to-five scale, came in and said their pain was at a three and the nursing staff was used to a zero-to-10 scale, we weren't comparing apples to apples."
With the JCAHO standards, the zero-to-10 scale with various smiley faces also used as an indicator, the entire hospital and other accredited auxiliary organizations, like Home Health Care and accredited nursing homes in the area, all use the zero-to-10 scale.
"Now we have continuity," Deafenbaugh said. "When a patient says the pain is four today, it is the same as last week's four.
"The pain is whatever the patient says the pain is.
"People will expect not to have any pain," she said, "and that just isn't true. Some people have different tolerances, different pain thresholds."
A young couple recently came to the hospital to have a baby and were expecting no pain. In fact, the father-to-be informed the staff, it was the law to be pain-free. He was quietly assured there would be some pain for his wife.
"Our realistic goal is to be able to make the pain minimal," she said. "Having a baby is going to hurt."
Pain is experienced after most surgeries and accidental injuries. Relief from pain assists in the patient's recovery.
The best pain medication is derived from opiolids which are narcotics. People fear becoming addicted to them.
"We counsel people that they're not taking an opiolid for the same psychological reason as an addict," she said.
"Hopefully it helps the patients feel like they're more in control of the decisions being made.
"We began looking at pain management before the JCAHO standards came out. It's more of an ethical thing for us."
"It's a prestigious thing to be accredited," Deafenbaugh said. "The hospital is willing to work extra hard for it. We're committed to give the best quality care that we can."
Despite these reassuring words, a needle inserted to draw blood will still sting and having a baby is going to be painful.
