Use of Subcutaneous Catheters for Pain Management in Hospitalized End-of-Life Patients: A Quality Improvement Project
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Date
2022-05
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The Ohio State University
Abstract
Uncontrolled pain profoundly impacts quality of life, often causing patients to experience physical, psychological, social, and spiritual distress. Although the intravenous (IV) route is a standard for pain medication administration in most acute care settings, subcutaneous (SC) infusion is an excellent alternative for effective pain control. The purpose of this quality improvement project was to evaluate if the development and implementation of an evidence-based subcutaneous catheter nursing policy with procedure improved pain management in patients during hospitalization. Pain ratings for a total of 19 patients were included. A comparison was done between patient pain ratings on Day 1 (0-24 hr) and Day 3 (48-72 hr) after SC catheter insertion. There was a statistically significant reduction in pain ratings from Day 1 to Day 3 (p<0.001) when analyzing aggregate data. A total of 18 patients (95%) had a decrease in pain ranging within 72 hours of SC catheter initiation with an average reduction of 3.36 points. The number of patients experiencing moderate or severe pain decreased by 50% on Day 3 (72 hr) compared to Day 1 (24 hr) and 58% of patients had a clinically significant reduction in pain of ≥ 2 points on the 0-10 DVPRS tool. Findings from this project support that pain medication administration through an indwelling subcutaneous catheter can be an effective and low-risk alternative to IV and oral therapy for managing patient pain in the acute care setting, especially for patients with difficult IV access or contraindications for oral medication therapy.
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Keywords
pain, subcutaneous, infusion, quality improvement, nursing