A Randomized Prospective Trial Investigating the Effectiveness of Various Interventions at Triage for Pain Relief in Adult Patients with Minor Musculoskeletal Injuries and Moderate Pain, and the Significance of Customer Satisfaction

2.50
Hdl Handle:
http://hdl.handle.net/10755/162764
Type:
Presentation
Title:
A Randomized Prospective Trial Investigating the Effectiveness of Various Interventions at Triage for Pain Relief in Adult Patients with Minor Musculoskeletal Injuries and Moderate Pain, and the Significance of Customer Satisfaction
Abstract:
A Randomized Prospective Trial Investigating the Effectiveness of Various Interventions at Triage for Pain Relief in Adult Patients with Minor Musculoskeletal Injuries and Moderate Pain, and the Significance of Customer Satisfaction
Conference Sponsor:Emergency Nurses Association
Conference Year:2000
Author:Tanabe, Paula, RN, PhD, CCRN
P.I. Institution Name:Northwestern Memorial Hospital
Contact Address:417 S. Jefferson Street #408B, Chicago, IL, 60607, USA
Contact Telephone:(312) 926-6999
Purpose: Minor musculoskeletal trauma injuries are common, and often associated with significant pain. These patients frequently wait due to low acuity. This can contribute to low patient satisfaction. The purpose of this study was to determine the most effective nursing intervention to decrease pain at triage.

Design: An interventional quasi-experimental study using a control group with repeated measures was used.

Setting: Data were collected at a suburban emergency department in the Midwest.

Sample: The sample included 77 adults age 18 and over presenting with a chief complaint of minor extremity trauma to the elbow or knee or below. Exclusion criteria were: inability to speak English, injury greater than 24 hours, self administration of any analgesics prior to arrival, lacerations, sensitivity to cold, Raynaud's phenomenon, rheumatoid arthritis to the effected joint, or a pain rating of 3 or less on a 0-10 numeric rating scale (NRS).

Methods: Trained research assistants were present at triage during busy hours to recruit and enroll patients. Random assignment was used to assign patients to 1 of 3 groups; (1) control (ice, immobilization, & elevation), (2) ibuprofen 800 MG po, or (3) distraction (audio cassette tapes with self-selected music). Patients rated their pain on the numeric rating or verbal descriptor scale (reliability and validity previously established) at 0, 30, & 60 minutes. Two questions regarding customer satisfaction were asked upon discharge from the ED.

Results: No differences in pain ratings between groups were demonstrated at 30 and 60 minutes. A statistically significant reduction in pain for all groups was reported at 30 minutes (F=21.17, p = 0.00001), and maintained at 60 minutes (F = 16.18, p =0.00001). Most patients (84%) stated they were more satisfied with their overall care in the ED because of the immediate attention they received at triage for pain relief. Patients who presented with higher pain ratings (equal among groups), expressed statistically significant lower satisfaction with pain management (F = 9.375, p = 0.003). Patients (87%) who listened to music stated they would like the opportunity in future ED visits.

Conclusions: Triage protocols should include ice and distraction techniques for pain. Ice provides a significant analgesic effect, and distraction improves patient satisfaction with the overall ED visit. [Research Paper Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleA Randomized Prospective Trial Investigating the Effectiveness of Various Interventions at Triage for Pain Relief in Adult Patients with Minor Musculoskeletal Injuries and Moderate Pain, and the Significance of Customer Satisfactionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162764-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Randomized Prospective Trial Investigating the Effectiveness of Various Interventions at Triage for Pain Relief in Adult Patients with Minor Musculoskeletal Injuries and Moderate Pain, and the Significance of Customer Satisfaction</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2000</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Tanabe, Paula, RN, PhD, CCRN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Northwestern Memorial Hospital</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">417 S. Jefferson Street #408B, Chicago, IL, 60607, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(312) 926-6999</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">ptanabe@nmh.org</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Minor musculoskeletal trauma injuries are common, and often associated with significant pain. These patients frequently wait due to low acuity. This can contribute to low patient satisfaction. The purpose of this study was to determine the most effective nursing intervention to decrease pain at triage.<br/><br/>Design: An interventional quasi-experimental study using a control group with repeated measures was used.<br/><br/>Setting: Data were collected at a suburban emergency department in the Midwest.<br/><br/>Sample: The sample included 77 adults age 18 and over presenting with a chief complaint of minor extremity trauma to the elbow or knee or below. Exclusion criteria were: inability to speak English, injury greater than 24 hours, self administration of any analgesics prior to arrival, lacerations, sensitivity to cold, Raynaud's phenomenon, rheumatoid arthritis to the effected joint, or a pain rating of 3 or less on a 0-10 numeric rating scale (NRS).<br/><br/>Methods: Trained research assistants were present at triage during busy hours to recruit and enroll patients. Random assignment was used to assign patients to 1 of 3 groups; (1) control (ice, immobilization, &amp; elevation), (2) ibuprofen 800 MG po, or (3) distraction (audio cassette tapes with self-selected music). Patients rated their pain on the numeric rating or verbal descriptor scale (reliability and validity previously established) at 0, 30, &amp; 60 minutes. Two questions regarding customer satisfaction were asked upon discharge from the ED.<br/><br/>Results: No differences in pain ratings between groups were demonstrated at 30 and 60 minutes. A statistically significant reduction in pain for all groups was reported at 30 minutes (F=21.17, p = 0.00001), and maintained at 60 minutes (F = 16.18, p =0.00001). Most patients (84%) stated they were more satisfied with their overall care in the ED because of the immediate attention they received at triage for pain relief. Patients who presented with higher pain ratings (equal among groups), expressed statistically significant lower satisfaction with pain management (F = 9.375, p = 0.003). Patients (87%) who listened to music stated they would like the opportunity in future ED visits.<br/><br/>Conclusions: Triage protocols should include ice and distraction techniques for pain. Ice provides a significant analgesic effect, and distraction improves patient satisfaction with the overall ED visit. [Research Paper Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:33:44Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:33:44Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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