Evidence-based Standardization of Postoperative Pain Management Guidelines at a Critical Access Hospital: Implementation and Evaluation of a Quality Improvement Project
Creators:Seale, Kevin R.
Advisor:Loversidge, Jacqueline M.
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Doctor of Nursing Practice Final Document Projects
Given the current healthcare climate regarding prescription drug use and the evolving opioid epidemic, prescribing practitioners, nurses, and patients alike struggle with how best to address postoperative pain management. Inconsistent application of the evidence, competing agendas, and personal bias in managing postoperative pain may influence the clinical practice of anesthesia. This QI project was conducted to evaluate whether consolidation of existing evidence-based postoperative pain management guidelines and implementation of a standardized analgesia guideline and analgesia policy and procedure would improve practice at a small critical access hospital in rural New England. Mixed methods were used to evaluate project success. A pre- and post-implementation survey including Likert scale and open-ended questions was used to assess CRNA and perioperative nurses' perception of effectiveness of the evidence-based standardized analgesia guideline to improve patients postoperative pain experience. Four CRNA's and eight perioperative nurses participated. Significant increases in mean scores for questions designed to assess participants current postoperative pain management practice as being evidence-based, and familiarity with published evidence-based guidelines for the management of postoperative pain were noted. Qualitative findings supported improvements in CRNA and perioperative nurses' perceptions of improved pain care outcomes following implementation. By mitigating prescribers' bias and facilitating standardization, this QI project demonstrated the value in utilizing evidence-based practice to improve the quality of anesthesia care and patients' postoperative pain experience.
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