Pain management at the bedside implementing the pain resource nurse role at luhs
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LOYOLA UNIVERSITY HEALTH SYSTEM. Loyola University Chicago. Pain Management at the Bedside : Implementing the Pain Resource Nurse Role at LUHS. Team Members: Jackie Murauski, Chair,

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Pain Management at the Bedside : Implementing the Pain Resource Nurse Role at LUHS

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LOYOLA

UNIVERSITY

HEALTH SYSTEM

Loyola University Chicago

Pain Management at the Bedside: Implementing the Pain Resource Nurse Role at LUHS

Team Members:

Jackie Murauski, Chair,

Liz Barstatis, Sandy Burgess, Anita Calistro, Gail Kellberg, Maureen Kolbusz, Cindi LaPorte, Aimee Stotz, LuAnn Vis, Carol White


The LUHS Pain Management Resource Nurse Team


Opportunity Statement

  • For the past 4 years there have been significant efforts to improve pain management for patients at LUHS.

  • Despite efforts, patient satisfaction with pain management remains in the lower third of hospitals in the Press Ganey database

    Project Goal:

    • To bring pain improvement efforts to the bedside, the LUHS Pain Resource Nurse (PRN) role was developed and implemented in 2002.


Pain Resource Nurse Role

  • An experienced health professional: Staff Nurse, Physical Therapist, Occupational Therapist

  • Receives special training in pain assessment & management

  • Develops and implements at least two unit based quality improvement goals for pain management

  • Serves as resource and change agent for their unit/department

  • Provides education to peers, patients, and families

  • Models collaboration with physicians and other health care providers to improve pain management


Most Likely Causes

  • Barriers to optimal pain management by staff include:

    • The subjective nature of pain

    • Varied staff knowledge levels related to optimal pain management

    • Limited staff involvement in organizational quality improvement efforts to improve pain management


Solutions Implemented

  • Conducted literature review

  • Communicated with other organizations that have implemented the PRN role

  • Gained organizational support for the program

  • Managers identified PRN candidates (Dec 01)

  • Organized & presented 2 day intensive course on pain management (Jan 02)

  • Conducted a PRN needs assessment (Feb 02)

  • PRN’s conducted a unit based needs assessment (Mar 02)

  • PRN’s developed two unit based improvement goals based on needs assessment (Apr 02)


Solutions Implemented

  • Supported role through:

    • Monthly meetings:

    • Continuing education on pain topics

    • Sharing of unit based activities by the PRN’s

    • Communication of organization improvement activities

    • Staff education materials

    • Development and distribution of LUHS Steps to Unrelieved Pain

  • Repeated PRN needs assessment after 1 year (Jan 03)

  • Repeated PRN orientation program (Jan 03)


LUHS PRN ProgramPRN Comfort Level After One Year

Improvement Noted in

18 of 20 aspects of care


Nursing Pain Documentation


Analysis

  • Eighty LUHS staff members participate in the PRN role

  • PRN comfort level has improved in 18 of 20 aspects of pain management after one year

  • LUHS nursing pain documentation has improved:

    • Admission notes: increased from 69.7% to 84% compliance

    • Discharge notes: Increased from 90.5% to 95% compliance

    • Several PRN’s conduct unit based documentation audits in addition to house-wide indicators

  • Eighty-six percent of PRN’s report that the role has made a difference on their unit


Next Steps

  • Continue to support the PRN role through monthly meetings

  • Provide continuing education on topics identified through the PRN needs assessment

  • Work with PRN’s on goal development and presentations of goals/outcomes to unit staff

  • PRN’s will educate peers on “Pain Talking Points” for use in patient/family education in 2003

  • Continue to identify program improvement opportunities


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