Impact of Hospital-Wide Comprehensive Pain Management Initiatives. (November 2017)

• Record Type: Journal Article
• Authors: Lester, Paula E.; Shehata, Janet; Fazzari, Melissa; Islam, Shahidul
• Is Part Of: American journal of medical quality. Volume 32:Number 6(2017:Nov./Dec.)
• Page Start: 591
• Page End: 597
• Publication Date: 2017-11
• Subjects: pain management -- inpatient hospital care -- interdisciplinary team approach -- systems-based practice; Medical care -- Quality control -- Periodicals; Medical care -- Evaluation -- Periodicals; Medical care -- Utilization review -- Periodicals; Medical care -- United States -- Periodicals; 362.1
• DOI: 10.1177/1062860616686683
• Languages: English
• ISSNs: 1062-8606

Abstract

This project aimed to improve pain management through clinician education, updated assessment tools, computer resources, and improved ordering and delivery systems. Clinicians were surveyed and results analyzed using Wilcoxon-Mann-Whitney testing and χ 2 testing. Prescribing patterns were evaluated by comparing proportions of prescription orders and dose intervals. Cochran-Armitage Trend Test was used for linear trends in proportion of prescription orders over time. Knowledge scores improved significantly for nurses ( P = .004) and nurse practitioners/physician assistants ( P < .0001). Patient surveys showed a reduction in the percentage of patients dissatisfied with pain control. There was a decrease of 3.6% in intramuscular orders of opioids ( P < .0001). A significant reduction was found in the percentage of orders of potentially high initial doses of opioids of hydromorphone and morphine after implementing an electronic alert. This project demonstrates that a comprehensive educational strategy with improved assessment tools, clinical resources, and educational programming can have a significant impact on pain management.