2.50
Hdl Handle:
http://hdl.handle.net/10755/203160
Type:
Presentation
Title:
KP Painscape – Taking Pain Management Beyond the 5th Vital Sign
Abstract:
(Improvement Science Research Network) Background: Approximately 50% of the post-operative patients report having received adequate pain relief during the course of their recovery1*. 1,2,3 The Joint Commission required hospitals to standardize practices around appropriate pain assessment and the management of pain using a scale for measurement (ie 0 – 10 scale).4 Purpose: Managing pain still remains challenging in a clinical setting.3,5,6 Materials & Methods: Better nursing communications needed.7, 8 Better collaboration amongst clinicians, patients and family to manage post-surgical pain.9 Practice Change: Individual Nursing Practice; Focused preparation before room visit; Probe Patient’s Pain, considering functional goals and ADLS; Most appropriate dose for initial transition to PO Pain Medications; Reassess the patient timely. Team Nursing Practice: Encourage around the clock dosing even if PRN is ordered; Cross-shift support to keep pain regimen going at night. Evaluation: Improved patient comfort; nurse’s understanding ways to provide pain management; Non-RN Clinical staff evaluation of nursing skill around pain management; Patient informed about pain management. Results: Decrease in patient’s pain variance2* of 23% on one pilot unit; Nurses showed better understanding of patients needs for pain management (+44%) and improved collaboration with patients (+25%); Non RN Clinicians ratings: Nurse’s Effectiveness (+27); Nurse’ Safer (+13%); Job Easier (+15%); Patients more informed (+19%). Conclusions: KP Painscape tested on medical units as well. Lessons Learned: Departments with a pain variance of greater than 1 have more opportunity for improvement. There seems to be a “sweet spot” between .5 and 1 as a range for optimal pain variance 1* Pain variance is the difference between the patient’s stated pain score and their acceptable pain level when a 1 – 10 scale is used. Results cited represent one unit for average pain variance between 5am and 9am. 2* 23 million in a 1992 report and 16.1 million in a 2004 report. Both state 50% or more getting inadequate pain relief. Bibliography: 1 http://www.ahrq.gov/clinic/medtep/acute.htm#acuteintro 2 Patient Safety and Quality – An Evidence-Based Handbook for Nurses, Chapter 17.Edited by Ronda G. Hughes. Rockville (MD): Agency for Healthcare Research and Quality (US); April 2008. Publication No.:08-0043. p. 2 3. McCaffery M. Pain management; problems and Progress. In: McCaffery M, Pasero C. Pain: clinical Manual. 2nd ed. St. Louis, MO: Mosby; 1999. p. 1 - 14 4. JCAHO. Comprehensive hospital accreditation Manual. Oakbrook Terrace, IL, 2001. 5. Apfelbaum JL, Chen C, Mehta S, et al. Postoperative pain experience: results from a national survey suggesting postoperative pain continues to be undermanaged. Anesth Analg 203:97:534-40 6. Hutchinson RW. Challenges in acute post operative pain management. Am J Health Systm Pharm 2007; 64(6 Suppl): S2- S5. 7. Gittell JH, Fairfield K, Bierbaum B, et al. Impact of Relational coordination on quality of care, postoperative Pain and functioning, and length of stay: A nine-hospital study of surgical patients. Med Care. 2002; 38 (8):807-819. 8. Horsley J, Crane J, Reynolds MA. Pain: DeliberativeNursing interventions. New York: Grune & Stratton, 1982 9. Car DR, Jacox AK, Chapman CR, et al. Acute pain Management: Operative or medical procedures and Trauma, No. 1. Rockville, MD: AHCPR pub. No. 920032; Public Health Service; U.S. Dept. of Health and Human Services, 1992. [© Improvement Science Research Network, 2011. http://www.improvementscienceresearch.net/.]
Keywords:
Pain Management; Vital
Repository Posting Date:
16-Jan-2012
Date of Publication:
3-Jan-2012
Sponsors:
UTHSCSA Improvement Science Research Network

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleKP Painscape – Taking Pain Management Beyond the 5th Vital Signen_GB
dc.identifier.urihttp://hdl.handle.net/10755/203160-
dc.description.abstract(Improvement Science Research Network) Background: Approximately 50% of the post-operative patients report having received adequate pain relief during the course of their recovery1*. 1,2,3 The Joint Commission required hospitals to standardize practices around appropriate pain assessment and the management of pain using a scale for measurement (ie 0 – 10 scale).4 Purpose: Managing pain still remains challenging in a clinical setting.3,5,6 Materials & Methods: Better nursing communications needed.7, 8 Better collaboration amongst clinicians, patients and family to manage post-surgical pain.9 Practice Change: Individual Nursing Practice; Focused preparation before room visit; Probe Patient’s Pain, considering functional goals and ADLS; Most appropriate dose for initial transition to PO Pain Medications; Reassess the patient timely. Team Nursing Practice: Encourage around the clock dosing even if PRN is ordered; Cross-shift support to keep pain regimen going at night. Evaluation: Improved patient comfort; nurse’s understanding ways to provide pain management; Non-RN Clinical staff evaluation of nursing skill around pain management; Patient informed about pain management. Results: Decrease in patient’s pain variance2* of 23% on one pilot unit; Nurses showed better understanding of patients needs for pain management (+44%) and improved collaboration with patients (+25%); Non RN Clinicians ratings: Nurse’s Effectiveness (+27); Nurse’ Safer (+13%); Job Easier (+15%); Patients more informed (+19%). Conclusions: KP Painscape tested on medical units as well. Lessons Learned: Departments with a pain variance of greater than 1 have more opportunity for improvement. There seems to be a “sweet spot” between .5 and 1 as a range for optimal pain variance 1* Pain variance is the difference between the patient’s stated pain score and their acceptable pain level when a 1 – 10 scale is used. Results cited represent one unit for average pain variance between 5am and 9am. 2* 23 million in a 1992 report and 16.1 million in a 2004 report. Both state 50% or more getting inadequate pain relief. Bibliography: 1 http://www.ahrq.gov/clinic/medtep/acute.htm#acuteintro 2 Patient Safety and Quality – An Evidence-Based Handbook for Nurses, Chapter 17.Edited by Ronda G. Hughes. Rockville (MD): Agency for Healthcare Research and Quality (US); April 2008. Publication No.:08-0043. p. 2 3. McCaffery M. Pain management; problems and Progress. In: McCaffery M, Pasero C. Pain: clinical Manual. 2nd ed. St. Louis, MO: Mosby; 1999. p. 1 - 14 4. JCAHO. Comprehensive hospital accreditation Manual. Oakbrook Terrace, IL, 2001. 5. Apfelbaum JL, Chen C, Mehta S, et al. Postoperative pain experience: results from a national survey suggesting postoperative pain continues to be undermanaged. Anesth Analg 203:97:534-40 6. Hutchinson RW. Challenges in acute post operative pain management. Am J Health Systm Pharm 2007; 64(6 Suppl): S2- S5. 7. Gittell JH, Fairfield K, Bierbaum B, et al. Impact of Relational coordination on quality of care, postoperative Pain and functioning, and length of stay: A nine-hospital study of surgical patients. Med Care. 2002; 38 (8):807-819. 8. Horsley J, Crane J, Reynolds MA. Pain: DeliberativeNursing interventions. New York: Grune & Stratton, 1982 9. Car DR, Jacox AK, Chapman CR, et al. Acute pain Management: Operative or medical procedures and Trauma, No. 1. Rockville, MD: AHCPR pub. No. 920032; Public Health Service; U.S. Dept. of Health and Human Services, 1992. [© Improvement Science Research Network, 2011. http://www.improvementscienceresearch.net/.]en_GB
dc.subjectPain Managementen_GB
dc.subjectVitalen_GB
dc.date.available2012-01-16T10:58:15Z-
dc.date.issued2012-01-03en_GB
dc.date.accessioned2012-01-16T10:58:15Z-
dc.description.sponsorshipUTHSCSA Improvement Science Research Networken_GB
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