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Ameliorating pain in nursing homes: a collaborative quality-improvement project
Rosa R Baier1, David R Gifford, Gail Patry
1Department of Community Health, Brown University, Providence, Rhode Island, USA. RBaier@riqio.sdps.org
Journal of the American Geriatrics Society
|December 2, 2004
Summary
A multifaceted intervention significantly improved pain management in nursing homes, increasing assessments and non-pharmacological treatments. This led to a substantial reduction in pain prevalence compared to facilities without the intervention.
Area of Science:
- Gerontology
- Health Services Research
- Pain Management
Background:
- Effective pain management in nursing homes is crucial for resident well-being.
- Existing processes of care and outcomes for pain management require improvement.
Purpose of the Study:
- To evaluate a multifaceted intervention designed to enhance pain management processes and outcomes in nursing home settings.
Main Methods:
- A quasi-experimental, pretest/posttest design was employed.
- The intervention involved audit and feedback, education, rapid-cycle quality improvement coaching, and inter-facility collaboration.
- Data were collected through chart reviews and the Minimum Data Set.
Main Results:
- Post-intervention, there were significant increases in appropriate pain assessments (3.9% to 43.8%) and non-pharmacological treatment use (40.5% to 81.9%).
- A 41.1% reduction in pain prevalence was observed in intervention facilities, compared to a 12.1% reduction in control facilities.
- Trends towards improved use of higher-step pain medications were noted, though not statistically significant.
Conclusions:
- The multifaceted intervention effectively improved key pain management processes of care.
- The intervention demonstrated a significant positive impact on pain outcomes, specifically reducing pain prevalence in nursing home residents.