Pain often goes unattended in nursing homes because of a breakdown in communications between nursing staff and clinicians, according to a Yale University School of Medicine study in the Archives of Internal Medicine.

Dr. Grace Y. Jeng, at Yale University School of Medicine in New Haven, CT, and her researchers interviewed directors of nursing at 63 nursing homes in New Haven County, asking them how often nurses assess residents’ pain, when nurses notify clinicians about the pain and when nurses reassess pain.

In 76% of facilities, nurses assessed pain in residents who did not complain of pain at least every three months. However, fewer than half assessed pain in residents with pain occurring at least once per shift. Only 42% of the time physicians were routinely notified of inadequate pain treatment regimens. Merely 55% of nursing directors reported that clinicians assessed pain at least once every one to two months.

Jeng suggested adopting standardized steps in pain management. That would optimize the flow of information about pain suffered by residents to nursing staff and to clinicians, she said.