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Alignment of pain reassessment practices and National Comprehensive Cancer Network guidelines
Cynthia Smith Idell1, Marcia Grant, Christina Kirk
1City of Hope National Medical Center, Duarte, CA, USA. cidell@coh.org
Purpose/Objectives:
To improve nursing pain reassessment practices using a research utilization model and advanced practice nurses (APNs).
Design:
A pre- and postintervention one-group design.
Setting:
A cancer hospital located in the western United States.
Sample:
42 oncology RNs from the inpatient staff of medical or surgical oncology units working at least 24 hours per week.
Methods:
National Comprehensive Cancer Network clinical practice guidelines were adopted. Interventions included one-on-one feedback regarding reassessment practices and nursing pain rounds. Instruments used were Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP), Pain Reassessment Data Tool, and Pain Competency Evaluation (PCE).
Main Research Variables:
Independent variables were pain rounds and one-on-one feedback. Dependent variables were PCE scores, percentage of pain reassessment documentation, and NKASRP test scores.
Findings:
Changing staff pain practices requires more than education. Barriers may be overcome through careful planning, using a systematic change process such as a research utilization approach. NKASRP and PCE scores and a percentage of reassessment documentation reached statistically significant increases postintervention.
Conclusions:
Adapting research recommendations allowed staff to create unit-specific solutions, evaluate practice changes, establish research partnerships, and use research in bedside care. Staff increased their proficiency in pain reassessment practices after the intervention.
Implications For Nursing:
Research utilization models bring about desired practice changes under APN leadership. Aligning pain reassessment practices with clinical pain guideline recommendations promotes improved pain management through better reassessment documentation.
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