title: Long-bone fracture pain management in the emergency department.
abstract: BACKGROUND
  The purposes of this study were to investigate the adequacy of pain management for patients with long-bone fractures seen in the emergency department and to determine whether racial disparities exist.
  
  
  METHODS
  The design was an exploratory, correlational design using patient data abstract ed from electronic medical records of 2 major urban medical centers located in the Southeastern United States. Data collected included demographics, time of initial pain assessment by the registered nurse, time of pain medication administration, severity of pain, fracture location by radiograph, type of pain medication, and route-dosage of pain medication administered. The primary outcome variable, which was the pain management index, was calculated and used as a measure of adequate pain management.
  
  
  RESULTS
  The majority of the sample (N = 218) was female (61%) and white (63%), with 28% black and about 10% of the sample consisting of other minorities. Seventy-nine (36%) of the 218 patients received no medication while in the emergency department despite a mean pain score of 6.9 (SD = 2.5) on a 0 to 10 scale representing moderate to severe pain. Patients who received pain medication (n = 126) waited for the medication 1.76 hours (±1.47). Among the patients who received an analgesic (n = 126), younger patients, black patients, and those with higher pain severity were more likely to receive inadequate pain management than were white patients.
  
  
  CONCLUSIONS
  According to the pain management index, the majority of the patients in this study received inadequate pain management while in the emergency department. Future interventions may need to focus on giving ED nurses information about inadequate pain management and disparities in pain management in the ED setting and exploring possible reasons for disparities in order to ultimately improve patient care.
authors: Byrdine F. Lewis School of Nursing, Georgia State University, Atlanta, GA 30302, USA. pminick@gsu.edu
authors: Ptlene
authors: P
authors: Minick
authors: Patricia C
authors: PC
authors: Clark
authors: Jo Ann
authors: JA
authors: Dalton
authors: Eva
authors: E
authors: Horne
authors: Debbie
authors: D
authors: Greene
authors: Monica
authors: M
authors: Brown
mesh_terms: D000700:Analgesics / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003710:Demography; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D050723:Fractures, Bone / Q000208:ethnology / Q000451:nursing*; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D059408:Pain Management / Q000451:nursing*; D010147:Pain Measurement
chemical_list: D000700:Analgesics