Trauma pain protocol: an interdisciplinary approach to process improvement.

Area of Science:

• Pain Management
• Trauma Care
• Nursing Practice

Background:

• Inconsistent pain management practices in trauma patients were identified, particularly during the transition from patient-controlled analgesia (PCA).
• Nursing staff reported frequent calls to clinicians for additional pain medication orders post-PCA discontinuation, indicating a need for improved transition protocols.

Purpose of the Study:

• To develop and evaluate an interdisciplinary protocol for managing pain in trauma patients.
• To address inconsistencies in transitioning patients from PCA to oral (PO) or intravenous (IV) pain medications.
• To improve nursing satisfaction and efficiency in pain management.

Main Methods:

• An interdisciplinary team developed a protocol encompassing PCA to PO/IV conversion, adjuvant medications, opioid reversal, and adverse effect management.
• A 4-month pilot study was conducted to assess the protocol's impact on pain management practices in trauma patients.

Main Results:

• The protocol implementation led to a reduction in medication order changes after PCA discontinuation.
• Nursing staff reported increased satisfaction with pain management.
• Nurses perceived a time savings due to fewer calls for pain medication modifications.

Conclusions:

• The developed trauma pain protocol provides an individualized and evidence-based approach for transitioning patients from PCA to PO/IV pain management.
• The protocol effectively addressed nursing concerns, improved pain management consistency, and enhanced operational efficiency.