Cancer pain treatment is a very important element of palliative care. The incidence of pain in patients with initial diagnosis of cancer is about 25%, and the incidence in patients with advanced stage is as high as 70%-90%. At present, the clinical practice of cancer pain treatment in China is not very standardized, and many problems need to be improved and solved. In order to further improve the standardized treatment of cancer pain in China, improve the quality of life of cancer patients, and ensure medical quality and safety, the Medical Secretary of the Ministry of Health has initiated the creation of 150 “Cancer Pain Standardized Treatment Demonstration Wards” nationwide by the end of 2013, and CSCO has promoted the implementation of this activity. At present, the activity has been fully launched and has attracted much attention, and the implementation standard of cancer pain standardized treatment demonstration ward is also expected by everyone. This article elaborates on three aspects: background, significance and focus of creating cancer pain standardized treatment demonstration ward and how to create cancer pain standardized treatment demonstration ward. In 1990, China first organized a national conference with the World Health Organization in Guangzhou to promote the World Health Organization’s principles of three-step pain treatment for cancer. 1991, China’s Ministry of Health promulgated the Notice on the Implementation of Three-step Pain Treatment for Cancer Patients in China. 2002, China’s State Drug Administration promulgated the Notice on the Implementation of Three-step Pain Treatment for Cancer Patients. In 2002, the State Drug Administration of China promulgated the Guidelines for the Use of Strong Opioids for Chronic Non-Cancer Pain and the Regulations for Cancer Patients to Apply for Special Narcotic Drug Cards. 2007, the Ministry of Health promulgated the Measures for Prescription Management. These regulations provide for the prescription of controlled and slow-release narcotic drugs for outpatients with cancer pain and patients with moderate to severe chronic pain, with a 15-day prescription for each prescription. The introduction of these regulations and management methods has ensured that our cancer patients can receive more effective and better cancer pain control. However, there are still many problems with the current status of cancer pain treatment in China: cancer pain treatment is in the popularization stage in most regions; inadequate pain treatment is still very common; clinicians still have insufficient knowledge of pain medications and lack sufficient experience in using them; and individualized treatment is gradually starting to be emphasized, but there is a lack of evidence-based medical evidence for reference. These are all things that we need to focus on and promote. Barriers to pain management include patients and families (lack of knowledge about cancer pain treatment, fear of opioid addiction, lack of social and psychological support), healthcare professionals (neglect of pain management, lack of knowledge about standardized cancer pain treatment, fear of opioid addiction) The barriers to the rational use of opioid analgesics (inadequate knowledge of opioid analgesics, fear of opioid addiction, over-regulation of opioid analgesics and inadequate supply) are still unresolved. How can we unite the efforts of all parties to promote the standardized treatment of cancer pain? How to remove the barriers to pain treatment? How to popularize cancer pain knowledge and improve cancer pain diagnosis and treatment research? How to make more patients understand more pain-related knowledge? We need to build a platform, which is the general background and starting point of creating a demonstration ward for standardized cancer pain treatment. “In order to further strengthen the management of standardized treatment of cancer, improve the level of standardized treatment of cancer pain, improve medical services for cancer patients, protect the legitimate rights and interests of cancer patients, improve the quality of life of cancer patients, improve medical quality and guarantee medical safety, the Medical Secretary of the Ministry of Health has decided to establish a nationwide demonstration ward for standardized treatment of cancer pain from 2011 to 2013. The Medical Secretary of the Ministry of Health has decided to carry out the activity of “Cancer Pain Standardized Treatment Demonstration Ward” nationwide from 2011 to 2013. By the end of 2013, 150 “Cancer Pain Standardized Treatment Demonstration Wards” will be created nationwide, and the Beijing Heath Science Clinical Oncology Research Foundation and Mengti (China) Pharmaceutical Co. Ltd. is responsible for the specific implementation of the “Model Ward” creation activities. Each provincial health administrative department is responsible for organizing and guiding the work related to the creation of “model wards” in hospitals under their jurisdiction. The General Office of the Ministry of Health issued a document to all provinces on March 31, 2011. The project has a very clear timetable, and it is planned to create 50 demonstration wards in three batches nationwide in three years, with 40 demonstration wards in the first batch in tertiary hospitals, 10 in secondary hospitals at prefectural and county levels, 30 in tertiary hospitals in the second and third batches, and 20 in secondary hospitals at prefectural and county levels. On August 22, 2011, the launch meeting of the national “Cancer Pain Standardized Treatment Demonstration Ward Creation Activity” was held in Taiyuan, Shanxi Province, and the launch meeting for doctors was held at the CSCO Academic Conference in September 2011, and the national creation activity was officially launched. This project is of great significance to improve the standardized treatment of cancer pain, guarantee medical quality and medical safety, improve medical services, improve patients’ quality of life, popularize and educate cancer pain knowledge, train specialized medical and nursing talents, promote palliative and supportive treatment of tumors, and create discipline brands. “The project focuses on three aspects: to popularize the analgesic knowledge of doctors and nurses and improve the level of analgesia; to strengthen the education of patients and their families; and to provide sufficient and complete pain relief drugs by the drug supply department. Regular inspection and assessment will eventually enable cancer pain patients to receive standardized treatment, increase the rate of pain control and improve patients’ quality of life. Establish regular inspection and assessment mechanism. How to create “Cancer Pain Standardized Treatment Demonstration Ward” Basic criteria of the department The applicant department is required to be an oncology department, a pain department or a department related to advanced cancer treatment and hospice care in a general hospital or a specialized oncology hospital of level II or above, approved and registered by the health administrative department. Oncology requires tertiary oncology specialty hospitals and tertiary general hospitals: ① carry out clinical diagnosis and treatment of oncology for more than 5 years, not less than 30 beds, annual admission of more than 800 cases of patients with intermediate and advanced tumors, to provide standardized pain treatment for cancer patients; ② have an independently set up oncology clinic, to provide outpatient services for cancer pain patients, annual cancer pain treatment of more than 240 cases or 1,500 cases;; ③ technical level to meet the technical standards of the specialized key departments of oncology in tertiary hospitals, in the province, autonomous regions and municipalities directly under the Central Government in the leading position of tertiary hospitals; ④ has a wealth of teaching experience, with the ability to train more than 5 cancer pain treatment physicians, more than 6 cancer pain treatment nurses each year. Level II oncology hospitals and level II general hospitals: ① carry out clinical treatment of cancer for more than 5 years, not less than 20 beds, annual admission of cancer patients more than 400 cases, able to provide standardized pain treatment for cancer patients; ② with independently set up oncology outpatient clinics, able to provide outpatient services for cancer pain patients, annual cancer pain treatment of more than 150 cases or 900 cases; ③ technical level in the province autonomous regions and municipalities directly under the Central Government in the leading position in the second-level hospitals; ④ have the experience and ability to train medical and nursing staff at the same level. The pain department is required to carry out pain diagnosis and treatment for more than 2 years and set up pain clinics. The pain department of tertiary hospitals is required to be able to independently carry out cancer pain treatment and other work, and carry out cancer pain treatment more than 150 cases or 1,000 cases per year; or the pain department admits more than 50 cases of cancer pain patients per year; and has the ability to train more than 3 cancer pain treatment physicians and more than 4 cancer pain treatment nurses per year. The pain department of secondary hospitals is required to be able to independently carry out cancer pain treatment and other work, and to carry out cancer pain treatment 80 cases or 500 cases per year; to have the experience and ability to train medical and nursing staff of the same level of medical institutions. Other advanced cancer treatment and hospice related departments refer to the above standards. There are also certain standards for the staffing of the department. Level III hospitals should have at least five medical and nursing staff dedicated to cancer pain assessment and treatment, including at least two physicians and three nurses. Grade II hospitals have at least 3 medical and nursing staff dedicated to cancer pain assessment and treatment, including at least one physician and two nurses. Doctors have ≥ 5 years of clinical treatment work in oncology or ≥ 2 years of clinical treatment work experience in pain medicine, and have professional and technical qualifications of attending physician or above. They should have a good grasp of the Regulations on the Administration of Narcotic Drugs and Psychotropic Substances, Prescription Management Measures, Regulations on the Administration of Pharmacy in Medical Institutions, Guidelines on the Clinical Application of Narcotic Drugs and Guidelines on the Clinical Application of Psychotropic Substances, etc. They should have a good grasp of the comprehensive pain assessment methods for cancer pain patients, the characteristics of various pain-relieving drugs, their use and the treatment of adverse reactions, and be able to independently carry out pain assessment and treatment for cancer pain patients. The nurse must have ≥ 3 years of experience in oncology medicine and clinical application principles. The nurse must have ≥ 3 years of nursing experience in oncology or ≥ 2 years of nursing experience in pain department, and have the qualification of professional technical position of nurse practitioner or above. Skilled in oncology and pain nursing skills, mastering pain scoring and pain nursing operation procedures, and able to assist physicians in the comprehensive assessment and treatment of cancer pain. They should be able to cooperate with physicians to do a good job in educating patients about cancer pain treatment. Basic management standards of the department There are also clear standards for the management of the department: the department should establish a standardized management system for narcotic drugs and psychotropic substances, improve the management system for narcotic drugs and psychotropic substances in accordance with the requirements of the Drug Administration Law of the People’s Republic of China, the Regulations on the Administration of Narcotic Drugs and Psychotropic Substances, the Measures for the Administration of Prescriptions, the Regulations on the Administration of Pharmaceutical Affairs in Medical Institutions and other documents, improve the working mechanism, optimize the management To improve the management system of narcotic drugs and psychotropic substances, improve the working mechanism, optimize the management process, ensure the convenient, adequate and reasonable use of pain relief drugs by patients, and meet the demand for clinical application of narcotic drugs and psychotropic substances. Establish and improve the system for standardized treatment of cancer pain. Establish a dynamic assessment mechanism for cancer pain; after the admission of cancer pain patients, physicians and nurses should complete comprehensive pain assessment within 8 hours, and dynamically assess the changes in pain level and nature, observe explosive pain episodes, factors related to pain reduction or aggravation and adverse reactions, etc., and deal with them accordingly; medical records should reflect the assessment and treatment of pain, with pain care sheets and pain scoring face charts beside hospital beds; Able to adjust the cancer pain treatment plan in a timely manner according to the changes of patients’ conditions. The dynamic assessment rate of cancer pain patients is ≥ 90%. Implement the patient informed consent system, fulfill the obligation to inform patients of their condition and respect their right to informed consent. Before implementing standardized cancer pain treatment, inform patients and their families of the purpose, risks, precautions, possible adverse reactions and preventive measures of cancer pain treatment. To implement individualized treatment for cancer pain, patients’ conditions are accurately evaluated and individualized treatment plans are formulated according to the Guidelines for the Clinical Application of Psychotropic Substances, the Guidelines for the Clinical Application of Narcotic Drugs, the WHO Three-step Pain Relief Principles, the NCCN Guidelines for Adult Cancer Pain and cancer pain treatment standards, and treatment is tailored to the disease. The treatment efficiency is ≥ 75%. Establish standardized treatment process for cancer pain, establish pain assessment and treatment process for cancer pain patients, and reasonably select treatment plan. The standardized treatment rate of cancer pain patients is ≥ 80%. Establish a consultation system for difficult and complicated cancer pain patients, establish a consultation mechanism, and organize consultation with physicians from oncology, pain department, pharmacy department and other related departments according to the needs of patients’ conditions to develop appropriate treatment plans. To establish a follow-up system for cancer pain patients, to conduct regular follow-up visits and cancer pain assessment and record for patients receiving standardized cancer pain treatment, so as to ensure that patients receive continuous, reasonable and effective cancer pain treatment. The follow-up rate of discharged cancer pain patients is ≥ 70%, and the pain assessment rate of outpatients with cancer pain is ≥ 95%. Establish a sound training system for medical and nursing personnel. ①Establish a regular training system for medical and nursing personnel. Organize medical and nursing personnel related to oncology treatment to receive training on standardized cancer pain treatment once a year. The annual training of medical and pharmacy personnel in tertiary hospitals is more than 300 times; the training of secondary hospitals is more than 100 times. ② Prepare a manual for standardized treatment of cancer pain for medical and nursing staff. In accordance with the requirements of cancer pain diagnosis and treatment standards, print the operation manuals and nursing manuals of physicians for standardized cancer pain treatment, and ensure that medical and nursing personnel related to cancer pain treatment have a copy. Establish patient education system. ①Establish a patient education system for cancer pain patients. Regularly hold cancer pain patient education lectures (at least once a quarter) and popularization training, and issue patient education manuals to educate patients and their families about cancer pain treatment. There is a public notice of the activity of creating “Cancer Pain Standardized Treatment Demonstration Ward” and a publicity board for pain treatment knowledge education, and the content of education is updated every quarter. It is required to post the face chart and pain scoring scale at the patient’s bedside to emphasize the importance of pain assessment and timely and dynamic assessment. The department posts forms regarding mission activities, develops mission plans, and conducts regular patient education activities. Other requirements There are also requirements for medical departments, pharmacy, and anesthesiology. The hospital director and department head coordinate the work related to standardized cancer pain treatment with relevant departments. (1) The medical department shall designate a person to be responsible for the creation of “cancer pain standardized treatment demonstration ward”, organize regular inspection of the activities, continuously summarize the experience, discover problems and rectify them in time, focusing on the treatment of cancer pain by physicians, analysis of the causes of death, medical safety guarantee, survival quality of patients after treatment, follow-up and case quality, (2) The pharmacy department should strictly comply with the requirements of the (2) The pharmacy department should strictly comply with the laws, regulations and rules such as the Drug Administration Law of the People’s Republic of China, the Regulations on the Administration of Narcotic Drugs and Psychotropic Substances and the Prescription Management Measures, and establish a complete management system and process for narcotic drugs and psychotropic substances. The company is able to provide necessary drugs in accordance with the WHO three-step pain relief principles; provide at least three varieties of opioid pain relief drugs and opioid poisoning relief drugs such as naloxone, and is able to deploy drugs in accordance with prescriptions and guide the rational use of clinical practice. Regularly conduct dynamic analysis of the use of cancer pain treatment drugs and provide guidance for the rational clinical use of narcotic drugs and psychotropic drugs. There is at least one clinical pharmacist in charge of cancer pain medication guidance. The clinical pharmacist has more than 1 year of work experience as a clinical pharmacist. (3) The Department of Anesthesiology should carry out clinical treatment of anesthesiology for more than 5 years and be equipped with anesthesia, monitoring and emergency equipment corresponding to the business of anesthesiology; more than 800 cases of general anesthesia and more than 1,500 cases of nerve block anesthesia are carried out independently in tertiary hospitals each year; more than 300 cases of general anesthesia and more than 800 cases of nerve block anesthesia are carried out independently in secondary hospitals each year. The specific declaration process is to create –> training –> declaration –> evaluation –> listing. Currently the activity has started in many cities, and more cities may participate after the document is issued. Through the above introduction, we hope that colleagues can have a deeper understanding of the creation of “Cancer Pain Standardized Treatment Demonstration Ward” and its criteria, and that relevant societies and associations can work together to promote the project and achieve the goal of improving the standardized comprehensive treatment of cancer pain in China. The goal is to improve the standardized comprehensive treatment of cancer pain in China.