Staff Nurses Use Evidence and Collaboration to Create a Geriatric Pain Assessment Tool and Change Hospital Policy

Tuesday, July 12, 2011: 2:25 PM

Martha Contreras, ADN
23 Tower, St. Luke's Episcopal Hospital, Houston, TX

Introduction: Ineffective pain control is a major quality of life factor that impacts patients’ hospital experience. Pain assessment can be a frustrating and complicated process, yet the relief of patients’ pain and promotion of comfort are essential to nursing practice. Evidence-based practices (EBP) regarding geriatric pain assessment and assessment tools were reviewed with regard to effectiveness and appropriateness. "Recent research shows that health care providers have many weaknesses, and that pain continues to be undertreated.”1 Research suggests that incorporating multidimensional facets of pain assessment and management provides best care and improves the geriatric patient’s quality of life. Research suggests that geriatric patients are more receptive to the Faces Pain Scale-Revised (FPS-R)2 rather than the commonly used Wong-Baker Faces Scale3.

 Methods:  Reviewed pain assessment and management policies. Reviewed current literature regarding geriatric-appropriate assessment tools. Collaborated with experts to implement a policy and practice change utilizing a culturally diverse evidence-based pain assessment tool. Developed and implemented an online survey to assess nurses’ knowledge and skill in assessing and managing geriatric patients’ pain. Secured authors’ permission to incorporate a copyrighted tool into hospital policy. Developed and distributed an education program and a brochure of best geriatric assessment practices to staff nurses.  Designed and distributed a hand-held pain assessment tool to enable appropriate pain assessment. Conducted a post-intervention online survey of nursing staff.  Analyzed data to evaluate the effectiveness of education based on post-intervention survey results.

 Evaluation: Over 660 staff nurses completed pre-intervention online survey. Preliminary data analysis demonstrated discrepancies that currently occur in practice relative to evidence-based best practices. Final analysis will be available at the time of the conference.

 Conclusions: Providing staff with valid and reliable pain assessment tools and educating them on their use is an important strategy to improve pain assessment and management of pain in geriatric patients.