Reducing time to analgesia in the emergency department using a nurse-initiated pain protocol: a before-and-after study.
Suboptimal management of pain in emergency departments (EDs) remains a problem, despite having been first described over two decades ago. A 'before-and-after' intervention study (with a historical control) was undertaken in one Western Australian tertiary hospital ED to test the effect of a 'nurse-initiated pain protocol' (NIPP) intervention. A total of 889 adult patients were included: 144 in the control group and 745 in the intervention group. Patients in the intervention group were: More likely to have a pain score recorded than those in the control group; have reduced median time to the first pain score; and reduced time to analgesia. The statistically significant reduction in both time to pain score and time to analgesia remained, even when adjusted by age and sex. Whilst we demonstrated the safety and efficacy of a NIPP in ED, an unacceptable proportion of patients continued to have inadequate pain relief.
Discipline of Emergency Medicine (M516), The University of Western Australia, Crawley, WA, Australia.
Judith C
JC
Finn
Amanda
A
Rae
Nick
N
Gibson
Roger
R
Swift
Tamara
T
Watters
Ian G
IG
Jacobs
D000293:Adolescent; D000328:Adult; D000698:Analgesia; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects; D016022:Case-Control Studies; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital; D059408:Pain Management / Q000379:methods*; D013996:Time and Motion Studies; D016896:Treatment Outcome
D000700:Analgesics