Authors (including presenting author) :
LAU SN (1), LAM HY (2), LI HY (1), CHAN TS (1), PANG HSI (1), LAM CY (1), CHONG YC (1)
Affiliation :
(1) Department of Medicine & Geriatrics, Ruttonjee & Tang Shiu Kin Hospitals, (2) Physiotherapy Department, Ruttonjee & Tang Shiu Kin Hospitals
Keyword 1: :
Pain assessment
Keyword 2: :
Pain control
Introduction :
Effective pain management in geriatric wards faces communication challenges between healthcare teams and patients. Reliable tools like the Numerical Rating Scale (NRS) and Faces Pain Scale-Revised (FPS-R) demonstrate strong correlation and validity for assessing pain intensity in elderly (Seif Rabiei et al., 2017; Karcioglu et al., 2018). These tools categorize pain into mild, moderate, and severe levels, aiding clinical decisions and interdisciplinary communication (Jones et al., 2007; Palos et al., 2006). This CQI project introduced the Traffic Light Pain Tool, a zone-based intervention (Green/Yellow/Red) based on NRS/FPS-R scores in an acute female geriatric unit to standardize and improve pain care.
Objectives :
The objectives were (1) to improve pain management proficiency through standardized pain intensity assessments; (2) to empower nursing staff and enhance interdisciplinary communication in pain management.
Methodology :
Over 8 weeks (late October to mid-December 2025), 33 patients reporting pain were recruited. The Traffic Light Pain Tool, including body diagrams and zone-specific interventions, was attached to bedside clipboards to raise awareness and team discussion. Pain scores and interventions were documented. 12 ward nurses received pain management training, with pre- and post-surveys evaluating knowledge, attitudes, and practices.
Result & Outcome :
The tool resulted in significant pain reduction: mean NRS decrease of 3.0 points (n=24, p< 0.001) and FPS-R decreased by of 4.0 points (n=9, p< 0.001). The tool supported tailored care through multidisciplinary interventions, including pharmacological approaches (97.0%, opioids in 12.1%), physiotherapy for pain relief (45.5%), radiological investigations (45.5%), specialist referrals (27.3%), and psychological approaches (21.2%). The tool also empowered nurse to identify and report pain issues unrelated to admission in 20/33 cases (60.6%) and initiate PRN medications (78.1% of pharmacological cases). Tool placement facilitated active nurse-to-doctor alerts, enhancing awareness and collaboration.
Staff surveys demonstrated increased knowledge (mean 3.0 to 4.08, p< 0.001), perception of relevance (3.25 to 4.25, p< 0.001), frequent use of NRS/FPS-R (reaching 100%/91.7%), and communication confidence (3.17 to 4.33, p< 0.001). Patient satisfaction with pain management rose significantly (3.42 to 4.17, p< 0.001).
The Traffic Light Pain Tool significantly improved pain management proficiency, resulting in substantial pain score reductions while fostering interdisciplinary communication and nursing staff empowerment. Enhanced staff confidence and patient outcomes confirm the tool effectively addresses geriatric pain management communication barriers.
