Learning Objective #1: Describe the six steps of a translation research model used to test best practices in non-drug interventions for postoperative pain management in older adults

Learning Objective #2: Discuss the efficacy, usefulness, and feasibility outcomes of evidence-based best practices for music, massage, and guided imagery to enhance older adults' postoperative pain management

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Purpose: The purpose of this study is to translate non-drug interventions for enhancing pain management into cost-effective, easy to use, best practice protocols for hospitalized older (>60) adults undergoing joint replacement (N=140) in an urban community hospital. A six-step "translating-research-into-practice" model (Collaborative Research Utilization Model) was used to test non-drug best practice protocols for music, guided-imagery, and massage. Specific aims were to:(1) pilot test efficacy of the best practices for decreasing pain intensity, lessening interference of pain with functional abilities, and improving satisfaction with pain management; (2) determine usefulness and feasibility of tailored patient teaching interventions related to the best practices, and (3) evaluate actual use of the interventions throughout hospitalization.

Methods: For efficacy outcomes, Brief Pain Inventory (BPI) scores for the study group were compared to controls before instituting the protocols, using ANCOVA, with group comparisons at three points along the care trajectory: (1) baseline (day of surgery) admission, (2) on postoperative day 3, and (3) on discharge. For feasibility, univariate descriptive statistics were used for surveying knowledge, attitudes, and behaviors. To survey actual use of enhancements, responses to the Non-drug Use Instrument were analyzed using descriptive univariate statistics.

Results: Preliminary findings suggest efficacy, feasibility, and usefulness of the model in translating these best practices. Data analysis will be completed in December, 2004.

Conclusions & Implications: Using this model to change clinician practice and sustain organizational change incorporates directions established by NINR, Healthy People 2010, and AHRQ to create meaningful change in practices to reduce the toll of physical pain on older people. Testing patient teaching materials tailored to information coping style is essential to enhancing non-pharmacological therapy. The potential for patients to use non-drug methods upon discharge may have a positive, sustained, self-regulated response to pain management in their future. (funded by the Mayday Foundation)