Characteristics of effective interventions supporting quality pain management in Australian emergency departments: an exploratory study.
BACKGROUND
It is well established that pain is the most common presenting complaint in Emergency Departments. Despite great improvements in available pain management strategies, patients are left waiting for longer than 60min for pain relief on arrival to the emergency department. The aim of this study was to describe interventions that lead to successful implementation of the National Health and Medical Research Council approved guidelines Acute Pain Management: Scientific Evidence (2nd Edition) that include specific recommendations for best practice pain management.


METHODS
A two-phased, mixed-method, exploratory study of all 52 Australian hospital emergency departments participating in the National Emergency Care Pain Management Initiative incorporating interview and document analysis was undertaken.


RESULTS
Interventions used by clinicians to improve pain management included nurse initiated analgesia, intranasal fentanyl for paediatric patients and lignocaine, and facio illiaca block. Education formed a major part of the intervention and the development of a working group of key stakeholders was critical in the successful implementation of change. Staff perceptions of patients' pain level and attitudes toward pain assessment and pain management were identified as barriers.


CONCLUSIONS
This study highlighted how an effective framework to plan and implement practice change and tailored interventions, including education and training systems and products using the best available evidence, best equipped clinicians to manage pain in the ED.
Griffith Health Institute, Research Centre for Clinical and Community Practice Innovation, Griffith University, Australia. r.shaban@griffith.edu.au
Ramon Z
RZ
Shaban
Kerri
K
Holzhauser
Kerri
K
Gillespie
Sue
S
Huckson
Scott
S
Bennetts
D000698:Analgesia / Q000706:statistics & numerical data; D000700:Analgesics / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D019468:Disease Management; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D010146:Pain / Q000453:epidemiology / Q000517:prevention & control*; D059408:Pain Management / Q000706:statistics & numerical data*; D010147:Pain Measurement / Q000379:methods*; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D016896:Treatment Outcome
D000700:Analgesics