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Evaluating the implementation of a pain management flow sheet

B A Joyce1, J F Keck, J E Gerkensmeyer

  • 1Department of Family Health Nursing, Indiana University School of Nursing, Indianapolis 46202, USA.

Journal of Pediatric Nursing
|November 11, 1999
PubMed

Insights

Implementing a new pain flow sheet for pediatric surgical patients did not improve overall pain documentation. However, it did increase documentation of nonpharmacological pain interventions, highlighting the need for better staff education on new clinical tools.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Healthcare Innovation

Background:

  • Effective pain management is crucial for pediatric surgical recovery.
  • Standardized protocols, like those from the Agency for Health Care Policy and Research (AHCPR), aim to improve pain assessment and treatment.
  • Innovation implementation in clinical settings often faces challenges.

Purpose of the Study:

  • To evaluate the impact of a new pain flow sheet on documentation practices for post-operative pediatric patients.
  • To assess adherence to Agency for Health Care Policy and Research (AHCPR) pain management guidelines.
  • To understand barriers to the successful implementation of new clinical documentation tools.

Main Methods:

  • Implementation of a pain flow sheet based on AHCPR guidelines in a pediatric surgical unit.
  • Evaluation of documentation changes in pain assessment, interventions, and outcomes.
  • Application of Rogers' Diffusion of Innovation Theory to analyze implementation outcomes.

Main Results:

  • The pain flow sheet was not utilized as intended, leading to no significant increase in overall pain assessment, intervention, or outcome documentation.
  • A notable increase was observed specifically in the documentation of nonpharmacological pain management interventions.
  • Rogers' Diffusion of Innovation Theory provided a framework for understanding the limited adoption of the new tool.

Conclusions:

  • The initial implementation of the pain flow sheet did not achieve its primary goal of enhancing comprehensive pain documentation.
  • Targeted improvements in nonpharmacological intervention documentation were noted.
  • More robust in-service education is essential for the successful integration of new clinical innovations, as suggested by innovation theory.

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