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Based on record review and interview, the facility failed to ensure that medications for the treatment of pain were reassessed in accordance with hospital policies and accepted standards of practice. This failure resulted in 3 of 4 patients (Patient #2, #4, and Patient #6) being administered a pain medication and not having a reassessment of the effectiveness of the medication.

Record review of the medication administration record of Patient #2 showed morphine 2mg was given on 3/6/17 at 2:25 AM for leg pain. There was not reassessment of the pain to determine the effectiveness of the morphine.

Record review of the medication administration record of Patient #4 showed morphine 2mg was given on 5/14/19 at 5:45 AM for abdominal pain. There was no reassessment of the pain to determine the effectiveness of the morphine.

Record review of the medication administration record of Patient #6 showed Norco 5/325mg was given on 5/13/19 at 7:57 AM. There was no reassessment of the pain to determine the effectiveness of the Norco.

In an interview with Staff #55 on 5/14/19 at 10:00 AM, Staff #55 stated that pain is to be reassessed to determine the effectiveness of a pain medication.

Record review of the policy, "Pain Assessment and Reassessment, Management, and Documentation," last reviewed 7/2017, showed: "Patients have the right to appropriate assessment and management of pain ... Pain will be reassessed after a pain intervention is performed. When administering non-PCA pain medications. Pain reassessment will be done within an hour of administering pain medications ... RN.LVN responsible for ... reviewing and documenting effectiveness of pain medication ..."

Record review of recommendations for improving the quality of acute and cancer pain management by D. Gordon and C. Miaskowski of the American Pain Society Quality of Care Task Force [2005; 165(14):1574-1580] showed: The American Pain Society published the most current guidelines in 2005 for improving the management of acute pain ... The 5 most current guidelines include prompt recognition and treatment of pain, involvement of patients in the pain management plan, improvement of treatment patterns, reassessment and adjustment of the pain management plan as needed, and monitoring processes and outcomes of pain management.