A Quality Initiative Incorporating Tablet Technology to Facilitate Nonpharmacologic Pain Intervention Use in the...

The opioid crisis has changed the culture and expectations of pain management, elevating the importance of nonpharmacologic pain interventions (NPIs) into multimodal pain management programs. Little is known about use of NPIs in hospitalized patients.

This quality improvement project aimed to increase awareness and use of NPIs by engaging patients and nurses on one medical unit using tablet technology.

Pre- and post intervention data were collected using surveys of nurse and nursing assistant perceptions of NPIs and by assessing pain management experiences of acute care patients using the American Pain Society-Pain Outcomes Questionnaire-Revised. Interventions included staff education, integration of an NPI menu and tools onto bedside tablets, and a Comfort Card communication tool.

This Quality Improvement project was conducted on an 18-bed adult medical unit at a Midwestern academic medical center.

Subjects included RN and Certified Nursing Assistants from one medical unit. Patient perspectives were obtained from a baseline cohort of 30 hospitalized medical patients and compared to an intervention group of 15 medical patients. Patient inclusion criteria included adults ages 18 and older, hospitalized ≤72 hours, who verbalized a willingness to participate.

The 8-week project included nurse and nursing assistant pre-/post-intervention perception surveys and an educational module about NPIs. Pain management experiences and NPI use were assessed post-tablet intervention using the American Pain Society-Pain Outcomes Questionnaire-Revised (APS-POQ-R). Additionally, staff education, integration of an NPI menu and tools onto bedside tablets, and a Comfort Card communication tool were planned interventions.

Nursing staff believe NPIs are beneficial, safe, and evidence-based; however, limited resources, time constraints, and lack of provider support are perceived as barriers. Staff and volunteers provided 80 comfort items to 38 patients during the project. Half of baseline patients (n = 30) and intervention (n = 15) groups reported not receiving information about pain treatment options. Many patients in both groups denied using "non medicine methods," but further assessment revealed that 90% of the baseline group and 87% of the intervention group had used an NPI.

Results suggest that patients and nurses may benefit from education about using NPIs in acute care. Nurses have a critical role influencing positive pain-related outcomes, and tablet technology can enhance patient use of NPIs during hospitalization.