June 23, 2011

VUMC nursing joins study to measure, improve patients’ pain care

VUMC nursing joins study to measure, improve patients’ pain care

Nurses at Vanderbilt University Medical Center are taking part in a multi-site study to implement evidence-based approaches to measure and improve pain care.

The study is funded by the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative and involves 400 hospitals across the nation.

“It takes a team to manage pain, and nurses are in a critical position on that team,” said Christine Kennedy, M.S.N., R.N., administrative director of inpatient medicine and study coordinator at VUMC. “When a patient’s pain isn’t well-managed, it is the nurse at the bedside who is making the decisions.

“The aim of this study is to develop a valid way to measure how effective we are at managing a patient’s pain and to be able to compare our rates to other hospitals.”

The study partners with the National Database of Nursing Quality Indicators (NDNQI), which has already developed data collection strategies for falls and pressure ulcers, and will replicate those methods regarding pain care.

The first phase of the study was completed in April and another round will be performed in November. On a given day across the country, trained nurses identify patients experiencing pain and ask questions that evaluate their pain experience. The de-identified data are reported to the principal investigators at the University of Utah College of Nursing for analysis.

The units participating at Vanderbilt are Orthopaedics and Urology on the fifth and sixth floorls of the Round Wing, Cardiovascular Surgical on 6 South, General Medicine on 8 North and Myleosuppression on 11 North.

The ultimate goal of the study is to develop standardized pain care quality measures that will improve a patient’s pain experience during their hospital stay.

Previous studies have shown that there is wide variability in how nurses assess pain, so standard measures are crucial.

“We know that patient satisfaction is not a good measurement of pain. Patients tend to say they are very satisfied, but looking back at their chart shows they had severe pain for a significant amount of time,” said Nancy Wells, D.N.Sc., R.N., director of Nursing Research. “This study hopes to find a standardized way a patient gives their report of pain.”

Kennedy said there is currently a lot of attention to effective pain management at VUMC, including a pain subgroup of the Medication Use & Safety Improvement Committee.

“Pain management is an art. There are now many different ways to deliver many different types of medications, and there is a lot of trust between nurses and their patients to be able to talk about pain. Patients may say they’re fine, but if they’re cringing or can’t take a breath, they’re not really fine,” Kennedy said.

“It is up to our nurses to make sure patients are comfortable, and this study is an important part of achieving that.”