Pilot Study of Comprehensive Sickle Cell Care Bundle During Acute Crisis Admissions

To evaluate the implementation of a comprehensive nonpharmacological pain management care bundle and associated length of stay in an acute care setting, mean pain score, morphine milligram equivalents, and engagement with nonpharmacological interventions among adults hospitalized with sickle cell disease pain crisis.

A single group, prepost pilot study involving a comprehensive care bundle was implemented on a single unit of an urban Midwestern hospital in December of 2024. The care bundle included the following caring-healing interventions: heat, pet therapy, massage, music listening, aromatherapy, authentic nursing presence, and referrals to spiritual care and nutrition services that the patient could select from. Average length of stay, average pain scores, first 24-hour total MME usage, and engagement with caring-healing interventions were derived from electronic medical records for adult patients with an admission before and after care bundle implementation.

Pre- and postimplementation data were collected for 17 patients from December 2024 to June 2025. The average length of stay increased from 4.64 to 4.94 days, while average pain scores decreased from 8.7 to 6.9. The number of patients receiving 10 or more caring-healing interventions rose from 5 to 14. While some patients evidenced a decrease in total MME in the first 24 hours, the overall change was not significant.

Implementation of a nonpharmacologic care bundle was used in adults hospitalized for SCD pain crisis and their use was associated with lower average pain scores.

Pain management nurses can use care bundles in acute care settings. These bundles may support multimodal and individual pain management for patients with sickle cell disease. The role of pain management nurses involves teaching nurses at the bedside as well as patients before and after their procedures or acute crisis.