2.50
Hdl Handle:
http://hdl.handle.net/10755/198359
Title:
Overcoming Obstacles to Excellent Pain Management in the Emergency Room
Abstract:
[ENA Annual Conference 2011 - Evidence-based Practice Presentation] Overcoming Obstacles to Excellent Pain Management in the Emergency Room

Purpose: Pain is the most common reason people come to the ER. 25 years after “oligo-analgesia” was first described in the literature, little headway has been made in treating and documenting pain. Under- treatment remains the most common problem in ERs nationwide.

Design: This is a P.I. project initiated and carried out by ER nursing staff

Setting: This project was set in a suburban NYC community hospital. The ER sees approximately 60,000 patients per year.

Participants/Subjects: The original chart audits/patient surveys were done in March and April 2009. After massive research and staff education, the audits/interviews are again being reprised currently (January/February 2011). Participants were randomly selected from all ER patients, regardless of sex or age, who sought treatment for pain or presented with a potentially painful chief complaint.

Methods: A three-pronged approach was used to explore the breadth and depth of this issue.
I. Chart Audit- 100 randomly selected patients’ charts were examined to ascertain charting compliance with hospital policy
II. Patient survey- designed by ER nurses and administered to 100 randomly selected ER patients during follow up discharge phone calls to ask them about their experiences with pain management during their stay in the ED
III. Practitioner Survey- designed to explore any prejudices, biases, or current perceptions of the MDs, mid level practitioners, and nurses related to pain management
Based on the results, the ER Pain Team embarked on a rigorous reeducation campaign consisting of lectures, posters, reminders, etc during the late summer/fall of 2010. We let our patients know that we are focused on their pain and comfort and that we would be aggressively addressing this priority.

Results/Outcomes: To date, our patient satisfaction scores have increased from 30% to >90% (Press Ganey) and in particular, pain management scores have risen from 26% in February ‘09 to 70% in October ’10. We are currently re-doing our original surveys/audits to measure our improvement against our initial benchmarks. In the meantime we are moving forward with continued reinforcement of individual aspects of our program.

Implications: Pain management continues to be an area of concern for ER nurses. Using the PI process, ER’s can begin to explore the depth of their pain management process and evaluate its effectiveness. Chart audits and surveys provide useful data to develop an action plan to improve pain management in ERs and the overall experience patient experience in the ED. Mediocrity does not have to be the status-quo. By following the evidence where it leads, nurses at the bedside can raise the bar and inspire colleagues to treat patients with the GOLD STANDARD.

Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011

Full metadata record

DC FieldValue Language
dc.titleOvercoming Obstacles to Excellent Pain Management in the Emergency Roomen_GB
dc.identifier.urihttp://hdl.handle.net/10755/198359-
dc.description.abstract[ENA Annual Conference 2011 - Evidence-based Practice Presentation] Overcoming Obstacles to Excellent Pain Management in the Emergency Room<br/><br/>Purpose: Pain is the most common reason people come to the ER. 25 years after “oligo-analgesia” was first described in the literature, little headway has been made in treating and documenting pain. Under- treatment remains the most common problem in ERs nationwide.<br/><br/>Design: This is a P.I. project initiated and carried out by ER nursing staff<br/><br/>Setting: This project was set in a suburban NYC community hospital. The ER sees approximately 60,000 patients per year.<br/><br/>Participants/Subjects: The original chart audits/patient surveys were done in March and April 2009. After massive research and staff education, the audits/interviews are again being reprised currently (January/February 2011). Participants were randomly selected from all ER patients, regardless of sex or age, who sought treatment for pain or presented with a potentially painful chief complaint. <br/><br/>Methods: A three-pronged approach was used to explore the breadth and depth of this issue.<br/>I. Chart Audit- 100 randomly selected patients’ charts were examined to ascertain charting compliance with hospital policy<br/>II. Patient survey- designed by ER nurses and administered to 100 randomly selected ER patients during follow up discharge phone calls to ask them about their experiences with pain management during their stay in the ED <br/>III. Practitioner Survey- designed to explore any prejudices, biases, or current perceptions of the MDs, mid level practitioners, and nurses related to pain management <br/>Based on the results, the ER Pain Team embarked on a rigorous reeducation campaign consisting of lectures, posters, reminders, etc during the late summer/fall of 2010. We let our patients know that we are focused on their pain and comfort and that we would be aggressively addressing this priority. <br/><br/>Results/Outcomes: To date, our patient satisfaction scores have increased from 30% to >90% (Press Ganey) and in particular, pain management scores have risen from 26% in February ‘09 to 70% in October ’10. We are currently re-doing our original surveys/audits to measure our improvement against our initial benchmarks. In the meantime we are moving forward with continued reinforcement of individual aspects of our program.<br/><br/>Implications: Pain management continues to be an area of concern for ER nurses. Using the PI process, ER’s can begin to explore the depth of their pain management process and evaluate its effectiveness. Chart audits and surveys provide useful data to develop an action plan to improve pain management in ERs and the overall experience patient experience in the ED. Mediocrity does not have to be the status-quo. By following the evidence where it leads, nurses at the bedside can raise the bar and inspire colleagues to treat patients with the GOLD STANDARD. <br/><br/>en_GB
dc.date.available2011-12-21T12:47:22Z-
dc.date.issued2011-12-21T12:47:22Z-
dc.date.accessioned2011-12-21T12:47:22Z-
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.