Impact of Hospital-Wide Comprehensive Pain Management Initiatives

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Abstract

This project aimed to improve pain management through clinician education, updated assessment tools, computer resources, and improved ordering and delivery systems. Clinicians were surveyed and results analyzed using Wilcoxon-Mann-Whitney testing and χ2 testing. Prescribing patterns were evaluated by comparing proportions of prescription orders and dose intervals. Cochran-Armitage Trend Test was used for linear trends in proportion of prescription orders over time. Knowledge scores improved significantly for nurses (P = .004) and nurse practitioners/physician assistants (P < .0001). Patient surveys showed a reduction in the percentage of patients dissatisfied with pain control. There was a decrease of 3.6% in intramuscular orders of opioids (P < .0001). A significant reduction was found in the percentage of orders of potentially high initial doses of opioids of hydromorphone and morphine after implementing an electronic alert. This project demonstrates that a comprehensive educational strategy with improved assessment tools, clinical resources, and educational programming can have a significant impact on pain management.

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