Completed Research Project
Evaluating the feasibility and effect of using a hospital wide coordinated approach to introduce evidence-based changes for pain management
Investigators: Williams AM, Oldham L, Toye C.
Funding: Australian Research Council Linkage Grant, Sir Charles Gairdner Hospital & St John of God Hospital, Subiaco
Administering institution: Curtin University
This action research project explored the feasibility and effect of implementing a hospital wide coordinated approach to improve the management of pain. Two acute care hospitals participated in this project, one public and one private. The project used a previously developed model to introduce three evidence-based changes in pain management. Part of this model included the introduction of 30 Pain Resource Nurses (PRNs) to act as clinical champions for pain at a local level. Both quantitative and qualitative measures were used to assess the feasibility and effect of the changes introduced.
Quantitative data were gathered through a hospital-wide document review and assessment of the knowledge and attitude of the PRNs at two time points. Time one: prior to the introduction of the PRNs and Time two: near completion of the project (11 months later). A statistically significant improvement in the documentation of pain scores on admission and each nursing shift was apparent. However, no difference in the percentage of patients who had been prescribed opioids for regular pain relief that had also been prescribed and dispensed a laxative/aperient was found. Neither was there any statistically significant decrease in the spot check pain scores carried out on patients at the time of the document review. An assessment of the knowledge and attitudes of the PRNs showed an improvement from Time one to Time two that was statistically significant.
Four sub-categories were identified in the qualitative data which described the experience of the Pain Resource Role: Becoming a Pain Resource Nurse, Aspects of the Role, Barriers to the Role, and Thoughts on the Future Role. Overall, the results revealed that the coordination of change using the new model of change incorporating PRNs, was a useful and effective method for introducing and sustaining evidence-based change.
