Evaluating the Feasibility and Effect of Using a Hospital-Wide Coordinated Approach to Introduce Evidence-Based Changes for Pain Management

Abstract

This action research project explored the feasibility and effect ofimplementing a hospital-wide coordinated approach to improve themanagement of pain. The project used a previously developedmodel to introduce three evidence-based changes in pain management.Part of this model included the introduction of 30 pain resourcenurses (PRNs) to act as clinical champions for pain at a locallevel. Both quantitative and qualitative measures were used to assessthe feasibility and effect of the changes introduced. Quantitativedata were gathered through a hospital-wide document review andassessment of the knowledge and attitude of the PRNs at two timepoints: time 1 before the introduction of the PRNs and time 2 nearcompletion of the project (11 months later). A statistically significantimprovement in the documentation of pain scores on admissionand each nursing shift was apparent. However, no differencewas found in the percentage of patients who had been prescribedopioids for regular pain relief that had also been prescribed anddispensed a laxative/aperient. Neither were any statistically significantdecreases in patient pain scores observed. An assessment of theknowledge and attitudes of the PRNs showed an improvement fromtime 1 to time 2 that was statistically significant. The qualitative datarevealed that despite the barriers encountered, the role was satisfyingfor the PRNs and valued by other hospital staff. Overall, theresults revealed that the new model of change incorporating PRNswas a useful and effective method for introducing and sustainingevidence-based organizational change.