Related Experiment Video
Updated: Aug 15, 2026

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
Using quality improvement to address pain management practices in nursing homes
Janice K Horner1, Laura C Hanson, Deborah Wood
1Medical Review of North Carolina, Inc., Cary, North Carolina, USA.
Abstract:
The objective of this study was to test whether a quality improvement intervention can improve pain management in nursing homes. Experts in quality improvement and clinical pain management provided nursing home staff leaders with feedback on pain quality indicator data, education in pain management, and technical assistance to apply the Plan-Do-Study-Act model of quality improvement. Trained abstractors completed structured chart audits at baseline and five months to capture quality indicator data related to pain assessment and treatment. Residents in pain who underwent pain assessments increased from 8% to 29% (P < 0.001). Residents receiving non-pharmacological pain treatments increased from 31% to 42% (P = 0.010), but pain medication use did not change. Among residents with daily moderate or excruciating pain, complete pain assessment was associated with increased probability of pain medication use. Quality improvement is a promising method to improve pain management in nursing homes.
Related Concept Videos
Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
Planning Nursing Care I
Angina V: Nursing Management
Ethical Issues
Ethical Concerns in Healthcare:
Peripheral Artery Disease IV: Nursing Management
Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.