General pain assessment among patients with cancer in an acute care setting: a best practice implementation project

This project sought to determine improve local practice in managing patients with cancer. It involved by: educating Registered Nurses on the importance of pain assessment, and ensuring this practice is done according to the current best available evidence and monitoring compliance with the audit criteria.

This project utilised a pre- and post-implementation audit strategy using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research Into Practice programs. It was implemented in three phases over a 6-month period, from September 2009 to February 2010. The audits utilised three out of 10 criteria recommended by The National Health Service Quality Improvement Scotland. The audits took place in a 24-bed oncology ward in a large acute care setting in Singapore involving a sample size of 24 patients and Registered Nurses. It involved going through the clinical charts and medical records of the cases, and educating Registered Nurses on pain assessment for patients with cancer.

The post-implementation audit findings indicated a modest to significant improvement in all the three criteria: first, an improvement of 33% through using a pain assessment tool to assess pain in patients with cancer; second, a 75% increase in the number of Registered Nurses who received education on pain assessment; and third, a 46% increase in accuracy in the assessment and documentation of pain.

The project had shown that pre- and post-implementation audits represent a useful method for translating evidence into practice. The conduct of this project showed that achieving change in clinical practice was challenging. It also showed that positive audit results were achieved through the enthusiasm, commitment and dedication of every member of the project team, the use of champions who were involved in direct patient care and performance feedback.