A Fresh Outlook on Pain Management: What is the Patient's Perspective?

Purpose:
The purpose of this study is to gather data from patients by asking them directly about their experience with pain, then implementing evidence-based approaches to measure and improve outcomes as related to pain management.

Background/Significance:
Improving pain care and outcomes is a common goal for health care professionals across the United States. In an effort to provide growth in the area of pain management, this hospital participated in a project with the National Database of Nursing Quality Indicators© (NDNQI) and the University of Utah as one of 400 hospitals to disseminate and implement evidence-based approaches to measure and improve pain care and outcomes.

Methods:
Phase I:surveyed patients on 9 units. Questions provided by NDNQI Pain Quality Indicator Set. Responses:aggregate responses at unit level:percentiles, median, mean, standard deviation,& number of units.1 unit chosen for Phase II:randomly assigned 1 of 3 levels of intervention.A med/surg oncology unit assigned as control group. 3 strategies to improve pain management: educating bedside staff & patients regarding controlling pain, using an acute pain management order set,using alternative pain therapy:pet therapy to eligible patients.Staff surveyed pre/post intervention assessing knowledge/attitudes regarding pain.Patients surveyed pre/post for satisfaction with pain management/interventions.

Results:
In Phase I of the study, census on this unit was 31 and 14 patients were eligible for the survey. Based on a 1-10 pain scale, 78.57% of patients scored 7 or above with 3 of those values scoring above benchmark. In spite of this, 100% of patient felt they had pain medication available to them when they needed it. Only 50% of patients felt nurses suggested alternative approaches to manage pain, and 57.14% felt the medications worked well. In Phase II, census was 36 with 9 patients eligible for the survey. Based on a 1-10 pain scale, 55.5% of patients scored 7 or above with values slightly below the benchmark, an improvement post interventions.

Conclusions and Implications for Practice:
Awareness exists about managing pain, yet studies indicate patients continue to have unacceptable levels of pain. We are aiming to improve the care related to pain and promote acceptance of key elements in pain management practice to minimize distress due to pain in hospitalized patients.