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Improving pain management in critical care
D R Caswell1, J P Williams, M Vallejo
1Department of Surgery, University of California at Los Angeles Center for Health Sciences, USA.
The Joint Commission Journal on Quality Improvement
|October 1, 1996
Summary
Implementing a quality improvement initiative significantly reduced patient pain scores in the Surgical Intensive Care Unit (SICU). The new guideline improved pain assessment and documentation, leading to better patient outcomes.
Area of Science:
- Quality Improvement in Healthcare
- Pain Management Strategies
- Intensive Care Unit (ICU) Patient Outcomes
Background:
- Pain management identified as a critical factor affecting patient outcomes in the SICU.
- A subcommittee was formed to address and improve pain management practices.
- The FOCUS-PDCA (plan-do-check-act) model was utilized for quality improvement.
Purpose of the Study:
- To decrease patient pain scores at the time of transfer from the ICU.
- To enhance the process of pain assessment and management.
- To implement evidence-based guidelines for acute pain management.
Main Methods:
- Pain assessment scores were measured pre- and post-intervention.
- Process control statistics were used to analyze the pain management process.
- A guideline for acute pain management was developed and implemented.
Main Results:
- A significant decrease in patient pain assessment scores at ICU transfer was observed.
- The percentage of patients reporting pain scores greater than 2 reduced from 35% to 21%.
- Improvements were noted in both pain assessment and documentation.
Conclusions:
- The quality improvement initiative, including the new guideline, was effective in improving pain management.
- Providing staff with appropriate tools for pain assessment and control was key to success.
- Ongoing improvements in pain management are being made.