Effective Pain Management and Improvements in Patients' Outcomes and Satisfaction

Purpose:
Apply successful initiatives implemented in an NDNQI study for improved pain management relative to patient satisfaction on medical/surgical units. Evaluate implemented strategies in identifying barriers in improving pain management, patient and staff education, and improved patient outcomes

Relevance/Significance:
Despite considerable advancements in pain management, the adverse physiologic and psychological implications of unmanaged pain remain substantially unresolved. Ineffective pain management can lead to a decrease in desirable clinical outcomes and patients overall quality of life. Advanced treatments in pain practice have made some improvement however little awareness of effectiveness of best practice persists. This nurse driven EBP practice supports innovations in improving quality patient care

Strategy and Implementation:
The direct results of the NDNQI study prefaced the development of a hospital-wide interdisciplinary pain team. The team implemented the successful initiatives from the study. The team consisted of the clinical nurse specialist, nurse manager, pharmacist, and the primary RN in partnership with the physicians, NP's and PA's. The initiatives were implemented January 2012 to May 2012 in which individual med-surg unit had 2 weeks of consistent daily pain rounding with the team. The daily pain rounding approach included assessing each patients pain and providing pain education to the patient and staff. Post-study pain score results were measured for a 20- month period thereafter. Nursing and pharmacy practices have significantly expanded as a result of EBP study, along with the engagement of physicians. Daily pain rounds led to significantly improved patient outcomes, improved pain management methods, and improved patient satisfaction.

Evaluation:
Results linked the initiatives with improved pain management.Pain scores measured by the NRC Corporation analyzed our results. Pre study patient pain scores demonstrated extreme variability in monthly scores,with the widest monthly margin of 50 points to post study scores reaching above the NRC National average with consistent monthly scores and a decrease of the widest monthly margin to13 points

Implications for Practice:
Daily pain rounds led to significantly improved patient outcomes,newly developed pain management methods and improved patient satisfaction.Increased engagement of physicians, pharmacists and nurses resulted in a sustained multidisciplinary approach providing effective pain management for patients