Nurses' use of the clinically aligned pain assessment tool: A mixed methods study

Area of Science:

• Nursing
• Pain Management
• Health Informatics

Background:

• Traditional pain assessment often relies solely on intensity ratings, potentially missing patient needs.
• A Midwestern medical center introduced the Clinical Aligned Pain Assessment (CAPA) tool to enhance nursing pain assessments.

Purpose of the Study:

• To describe nurses' experiences using the CAPA tool on an adult general medicine unit.
• To evaluate the documentation of the CAPA tool in the electronic health record (EHR) over five years post-implementation.

Main Methods:

• A mixed-methods exploratory sequential design was employed.
• Two focus groups with nurses (N=8) explored CAPA usage, assessment effectiveness, intervention determination, and challenges/advantages.
• Patient EHR data (N=373) were analyzed for CAPA documentation patterns.

Main Results:

• Qualitative themes revealed benefits, a more comprehensive pain picture, varied CAPA application, and challenges.
• Quantitative data showed frequent documentation in the comfort domain and earlier reassessment for higher pain levels.
• Mixed-methods analysis indicated variability in CAPA domain documentation and reassessment practices.

Conclusions:

• Nurses' role as patient advocates is crucial for effective pain assessment and treatment.
• Methodological research on the CAPA tool is necessary.
• Ongoing monitoring of CAPA administration, coding, and decision-making is essential for optimal pain management.