title: Task-shifting Using a Pain Management Protocol in an Emergency Care Service: Nurses' Perception through the Eye of the Rogers's Diffusion of Innovation Theory.
abstract: It has been shown that over 70% of patients waiting in emergency departments (EDs) do not receive analgesics, despite the fact that more than 78% complain of pain. A clinical innovation in the form of a pain management protocol that includes task-shifting has been implemented in the ED of a university hospital in Switzerland in order to improve pain-related outcomes in patients. This innovation involves a change in clinical practice for physicians and nurses. The aim of this study is to explore nurses' perceptions on how well this innovation is adopted. This descriptive correlational study took place in the ED of a Swiss university hospital; the hospital provides healthcare for the city, the canton, and adjoining cantons. A convenience sample of 37 ED nurses participated. They were asked to complete a questionnaire comprising 56 statements based on Rogers's "Diffusion of Innovation" theory. Nurses' opinions (on a 1-10 Likert scale) indicate that the new protocol benefits the ED (mean [M] = 7.4, standard deviation [SD] = 1.21), is compatible with nursing roles (M = 8.0, SD = 1.9), is not too complicated to apply (M = 2.7, SD = 1.7), provides observable positive effects in patients (M = 7.0, SD = 1.28), and is relatively easy to introduce into daily practice (M = 6.5, SD = 1.0). Further studies are now needed to examine patients' experiences of this innovation.
authors.affiliation: Department of Medicine, Vaud University Hospital, Lausanne, Switzerland. Electronic address: Fabienne.Hadorn2@chuv.ch.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Hadorn
authors.affiliation: University of Applied Sciences and Arts - Western Switzerland, ARC University of Applied Sciences, Switzerland.
authors.forename: Pascal
authors.initials: P
authors.lastname: Comte
authors.affiliation: Emergency Services, Vaud University Hospital, Lausanne, Switzerland.
authors.forename: Eliane
authors.initials: E
authors.lastname: Foucault
authors.affiliation: Emergency Services, Vaud University Hospital, Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Diane
authors.initials: D
authors.lastname: Morin
authors.affiliation: Emergency Services, Vaud University Hospital, Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Hugli
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004059:Diffusion of Innovation; D016529:Emergency Nursing / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009741:Nursing Staff, Hospital / Q000523:psychology*; D059408:Pain Management / Q000379:methods* / Q000451:nursing*; D011795:Surveys and Questionnaires; D013557:Switzerland