Journal Article10.1111/J.1532-5415.2004.52553.X
Ameliorating Pain in Nursing Homes: A Collaborative Quality‐Improvement Project
Rosa R. Baier,David R. Gifford,Gail Patry,Sara M. Banks,Therese Rochon,Debra DeSilva,Joan M. Teno +6 more
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TL;DR: The aim is to evaluate a multifaceted intervention to improve pain‐management processes of care and outcomes in nursing homes.
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Abstract: Objectives: To evaluate a multifaceted intervention to improve pain-management processes of care and outcomes in nursing homes.
Design: Quasi-experimental, pretest/posttest.
Setting: Nursing homes in Rhode Island.
Participants: Twenty-one facilities.
Intervention: This project used a multifaceted collaborative intervention involving audit and feedback of pain management, education, training, coaching using rapid-cycle quality-improvement techniques, and inter-nursing home collaboration.
Measurements: Pain-management processes of care and outcomes, measured using chart review and the Minimum Data Set.
Results: Of 21 facilities, 17 completed the project. Postintervention, nursing homes increased the use of appropriate pain assessments (3.9% vs 43.8%, P<.001), pain intensity scales (15.6% vs 73.9%, P<.001), and nonpharmacological treatments (40.5% vs 81.9%, P<.001). Prescriptions of World Health Organization Step II or Step III pain medications for residents with daily moderate or severe pain showed trends towards improvement (40.8% vs 50.6%, P=.057), but prescription of any pain medication (93.3% vs 94.6%, P=.710), change in pain medication (29.0% vs 30.1%, P=.386), and prescription of pain medications on a regularly scheduled basis (67.9% vs 69.5%, P=.370) did not. There was a 41.1% reduction in prevalence of pain (12.2% vs 7.2%, P=.032) between the pre- and postintervention time periods in the nursing homes that completed the project, whereas all the other facilities in Rhode Island (n=72) had only a 12.1% reduction (12.7% vs 11.2%, P=.286) during the same period.
Conclusion: A multifaceted intervention improved pain-management process and outcome measures in nursing homes.
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Heather Davila
- 01 Nov 2018
Abstract: University of Minnesota Ph.D. dissertation. November 2018. Major: Organizational Leadership, Policy, and Development. Advisor: David Johnson. 1 computer file (PDF); v, 211 pages.
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Effect of an Educational and Organizational Intervention on Pain in Nursing Home Residents: A Nonrandomized Controlled Trial
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