Clinical Nurse Specialist Implementation of a Pain Management Initiative Using The Iowa Model of Evidence-Based Practice to Promote Quality Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/164105
Category:
Abstract
Type:
Presentation
Title:
Clinical Nurse Specialist Implementation of a Pain Management Initiative Using The Iowa Model of Evidence-Based Practice to Promote Quality Care
Author(s):
Rich, Kathleen
Author Details:
Kathleen Rich, PhD, RN, CCNS, CCRN-CSC, CNN, La Porte Regional Health System, La Porte, Indiana, USA, email: nacnsorg@nacns.org
Abstract:
PURPOSE/OBJECTIVES: Nursing has a primary responsibility in pain management including educating, using pain assessment tools, writing policies and developing quality indicators to meet this measure. A potential exists for nursing pain activities to have a very narrow focus; concentrating on pain relief, primarily through opioid administration, while neglecting or omitting assessments on the potential for injurious medication side effects. This purpose of this presentation is to discuss how the Clinical Nurse Specialist utilized The Iowa Model of Evidence-Based Practice to Promote Quality Care in changing a limited scope pain management practice within a facility. SIGNIFICANCE: The CNS identified problem and knowledge-focused triggers including risk management data findings along with a knowledge deficit by nursing. These included omission of physiologic assessments, lack of medication knowledge by the nursing staff along with equipment deficiencies. The identified triggers resulted in the institution acknowledging pain management to be a priority issue. BACKGROUND/RATIONALE: The CNS assembled and led a multidisciplinary team consisting of administration, nursing staff, managers, education, pharmacy, risk management and quality improvement in reviewing the evidence-based pain guidelines. A member of the medical staff acted as liaison. DESCRIPTION: Current practices and policies were examined. In addition at the committee's request, the CNS conducted several additional studies including an analysis of Rapid Response Team (RRT) calls and a medication administration cost breakdown to support the need for change. Outcome: Multiple nursing practice revisions were recommended and implemented by the team in two stages over a nine-month period. These included: equipment purchase, policy revisions, developing patient literature, nursing staff education, documentation modification and new physician orders. INTERPRETATION/CONCLUSION: Evaluation of these evidence-based practice changes has resulted in a significant reduction in opioid-related RRT calls, a negligible change in cost and improvement in both staff and patient satisfaction. Implications for Practice: Updating any clinical practice to conform to the current evidence is not a static process; it is dynamic and ongoing. The Iowa Model of Evidence-Based Practice to Promote Quality Care was the framework utilized by the CNS in this pain initiative. The CNS-led multidisciplinary team successfully implemented evidence-based practice changes in the nursing care of patients with pain while subsequently improving outcomes.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2010
Conference Name:
CNS as Interal Consultant: Influencing Local to Global Systems
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Portland, Oregon, USA
Description:
Conference theme: CNS as Internal Consultant: Influencing Local to Global Systems, held March 3 - 6, Portland, Oregon, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleClinical Nurse Specialist Implementation of a Pain Management Initiative Using The Iowa Model of Evidence-Based Practice to Promote Quality Careen_GB
dc.contributor.authorRich, Kathleenen_US
dc.author.detailsKathleen Rich, PhD, RN, CCNS, CCRN-CSC, CNN, La Porte Regional Health System, La Porte, Indiana, USA, email: nacnsorg@nacns.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164105-
dc.description.abstractPURPOSE/OBJECTIVES: Nursing has a primary responsibility in pain management including educating, using pain assessment tools, writing policies and developing quality indicators to meet this measure. A potential exists for nursing pain activities to have a very narrow focus; concentrating on pain relief, primarily through opioid administration, while neglecting or omitting assessments on the potential for injurious medication side effects. This purpose of this presentation is to discuss how the Clinical Nurse Specialist utilized The Iowa Model of Evidence-Based Practice to Promote Quality Care in changing a limited scope pain management practice within a facility. SIGNIFICANCE: The CNS identified problem and knowledge-focused triggers including risk management data findings along with a knowledge deficit by nursing. These included omission of physiologic assessments, lack of medication knowledge by the nursing staff along with equipment deficiencies. The identified triggers resulted in the institution acknowledging pain management to be a priority issue. BACKGROUND/RATIONALE: The CNS assembled and led a multidisciplinary team consisting of administration, nursing staff, managers, education, pharmacy, risk management and quality improvement in reviewing the evidence-based pain guidelines. A member of the medical staff acted as liaison. DESCRIPTION: Current practices and policies were examined. In addition at the committee's request, the CNS conducted several additional studies including an analysis of Rapid Response Team (RRT) calls and a medication administration cost breakdown to support the need for change. Outcome: Multiple nursing practice revisions were recommended and implemented by the team in two stages over a nine-month period. These included: equipment purchase, policy revisions, developing patient literature, nursing staff education, documentation modification and new physician orders. INTERPRETATION/CONCLUSION: Evaluation of these evidence-based practice changes has resulted in a significant reduction in opioid-related RRT calls, a negligible change in cost and improvement in both staff and patient satisfaction. Implications for Practice: Updating any clinical practice to conform to the current evidence is not a static process; it is dynamic and ongoing. The Iowa Model of Evidence-Based Practice to Promote Quality Care was the framework utilized by the CNS in this pain initiative. The CNS-led multidisciplinary team successfully implemented evidence-based practice changes in the nursing care of patients with pain while subsequently improving outcomes.en_GB
dc.date.available2011-10-27T11:42:07Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:42:07Z-
dc.conference.date2010en_US
dc.conference.nameCNS as Interal Consultant: Influencing Local to Global Systemsen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationPortland, Oregon, USAen_US
dc.descriptionConference theme: CNS as Internal Consultant: Influencing Local to Global Systems, held March 3 - 6, Portland, Oregon, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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