title: Trauma pain protocol: an interdisciplinary approach to process improvement.
abstract: The trauma pain protocol was developed in response to nursing staff concerns regarding pain management practices and hospital-wide goals. Data collected on pain management practices within the trauma patient population identified inconsistencies with the transition of patient-controlled analgesia (PCA) to oral (PO) and intravenous (IV) pain medications. Nursing staff cited concerns with the frequent need for calls to clinicians to obtain additional pain medication orders following discontinuation of PCA. An interdisciplinary team developed a protocol to address appropriate PCA to PO/IV conversion, adjuvant medications, opioid reversal, and management of adverse effects. Data collected from a 4-month pilot of the protocol demonstrated a reduction in changes made to PO/IV medications following discontinuation of PCA. Nursing response to the protocol included increased satisfaction with pain management practices and a perception of time saved through reduced need for calls to clinicians for additional pain medication modifications. We conclude that this protocol results in a more individualized, evidence-based transition from PCA to PO/IV.
authors.affiliation: Medical University of South Carolina, Charleston, SC, USA. stacey.seipel@yahoo.com
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Seipel
authors.forename: Megan Bales
authors.initials: MB
authors.lastname: Fulton
authors.forename: Brian P
authors.initials: BP
authors.lastname: McKinzie
authors.forename: Lauren
authors.initials: L
authors.lastname: Parnell
mesh_terms: D000284:Administration, Oral; D016058:Analgesia, Patient-Controlled / Q000379:methods / Q000451:nursing*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D033183:Interdisciplinary Communication; D008297:Male; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000451:nursing; D010348:Patient Care Team / Q000458:organization & administration*; D017060:Patient Satisfaction; D018570:Risk Assessment; D012720:Severity of Illness Index; D014193:Trauma Centers; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications* / Q000175:diagnosis / Q000601:surgery
chemical_list: D000701:Analgesics, Opioid