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In 1996, Altru Health System in Grand Forks, North Dakota formed a multidisciplinary Pain Management Committee to facilitate the improvement of pain assessment and management for patients in the institution. Healthcare institutions must collect and establish their own database in order to demonstrate the need for change within the institution. An extensive internal investigation of patient pain experiences and healthcare professionals' knowledge and pain management practices was conducted in 1997. Findings indicated overall patient satisfaction with pain management practices despite reporting their average level of pain during hospitalization as a mean of 5.61 (on a scale of 0-10 with 10 representing the worst level of pain). The study indicated need for improvements in knowledge about pain management for all professions surveyed including pharmacists, physicians, and nurses. Data obtained from the study directed agency pain management practice changes along with implementation of professional education. In 2002, a replication study was conducted to assess the impact of the initiatives. A non-randomized convenience sample of patients and health care providers were used to assess the effect of patient education and the current level of patient satisfaction with the pain care received. The survey tools were developed by the agency's Pain Management Committee and had a cronbach's alpha of 0 .9 and the validity coefficient, using the split-half technique, was 0.93. Overall, knowledge and attitude scores for health care professionals improved significantly (p <.01) over the five year timeframe. Patient satisfaction with pain management practices and the health care professionals' response to their pain needs improved significantly (p < .01) as well. While results are encouraging, a few problem areas were identified in health care professionals' knowledge and patient attitudes concerning their rights for pain relief.
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