Paper
Saturday, July 14, 2007
This presentation is part of : Strategies for EBN Implementation
Benchmarking Nursing Care Quality Indicator for Pain in a Quaternary Health Care Institution
Andréa Maria Laizner, BScN, MSc(A), PhD1, Suzanne Watt, RN, BScN, MSc(A)1, and Krista Margaret Brecht, RN, BScN, MSc(A)2. (1) Nursing, McGill University Health Centre, Montreal, QC, Canada, (2) Nursing and Anaesthesia, Mcgill University Health Centre, Montreal, QC, Canada
Learning Objective #1: understand the process used for benchmarking nursing quality care indicators.
Learning Objective #2: identify the need for an organization to compare itself with other organizations on specific quality care indicators.
BACKGROUND. Our organization is a quaternary multi-site academic health care institution with 1200 beds. As part of our quality assurance, we conducted a pain prevalence survey in 2004 of 732 patients (pediatric and adult patients) that was repeated in 2005 and 2006. This presentation will explore challenges faced by our Task Force on Pain and Symptom Management when deciding how to benchmark pain assessment and management within our organization against that of other organizations. We needed to identify the nursing quality care indicator for pain that would be reported on the balanced scorecard (e.g. mean pain score versus percentage of patients reporting mild, moderate or severe pain). One of the challenges was that we decided for our first survey to use the Brief Pain Inventory (BPI) Short form developed by Cleeland (1992) for use with cancer patients.

METHOD. We conducted a literature search to identify previously conducted pain prevalence surveys. We identified some that had used a numeric rating scale or visual analogue scale, including the BPI. Populations of the benchmark studies varied based on age, culture/ethnic background of the patients (Canada, Italy, Australia, Germany, USA, and France) and diagnostic category (homogeneous sample: surgical, oncology versus heterogeneous or mixed: medicine and surgery). Studies generally excluded psychiatry and emergency room patients.

RESULT. Prevalence survey reports from four countries were retained. We excluded prevalence surveys of community populations, small sample sizes, and gave preference to those that used the BPI or measured pain using a numeric rating scale in a heterogeneous sample that represented at least medical and surgical patients. We decided to include psychiatric and emergency room patients in our annual survey.

RELEVANCE. This presentation will identify the selected studies and criteria used for the benchmarking exercise. This would be of interest to any organization considering benchmarking quality of care indicators.

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