The goal of conducting a pain assessment study is to evaluate the effectiveness of the unit’s current pain assessment and management practices. This will help identify opportunities to better meet patients’ needs and improve outcomes. When planning such a study, here are the key steps to follow:
First, define the objectives of the study clearly. The overarching goal would be to evaluate current pain assessment and management practices and identify areas for improvement. More specific objectives may include assessing the frequency and thoroughness of pain assessments, timeliness of analgesia administration, adequacy of pain control, documentation of pain evaluations, and patient satisfaction with pain management.
Second, design the study methodology. This pain assessment study would utilize a retrospective medical record review as well as a prospective patient interview component. For the medical record review, a sample of patient records from the past 6 months would need to be selected randomly. Criteria for inclusion may be adult patients who were hospitalized for 3 or more days and had documented pain. Data to abstract from the records would include demographic details, nursing documentation of pain assessments, PRN analgesia administration records, patient reported pain scores over time, and discharge summaries.
For the prospective component, a convenience sample of current patients expected to stay 3 or more days who report pain would be asked to participate. After obtaining informed consent, these patients would be interviewed using a standardized questionnaire to assess their perceptions and satisfaction with the unit’s pain management approach. It would also be valuable to interview nurses and physicians to understand current practices from their perspective.
Third, develop the appropriate data collection tools needed for the study. For the medical record review, an abstraction form would need to be created to systematically extract the required data points from each selected record in a uniform manner. The patient and staff interview questionnaires would also need to be developed, with mostly closed-ended questions to facilitate quantification and analysis of responses. All tools must be pre-tested on a small sample to ensure they can reliably collect the intended data.
Fourth, obtain the necessary approvals from the hospital’s Institutional Review Board to conduct the study involving human subjects. The study protocol, purpose, methodology, potential risks/benefits, privacy and data security measures would need to be reviewed and approved. Recruitment materials like flyers and consent forms for patients and staff would also require IRB approval.
Fifth, implement the study by recruiting participants and collecting the data as planned. This would involve screening medical records randomly based on the selection criteria, identifying eligible patients on the unit, explaining the study and obtaining consent, conducting interviews at patients’ bedsides while minimizing disruption, and extracting data from medical records using the abstraction tool. Frontline nurses and physicians providing direct care would also need to be recruited to participate in brief interviews during non-busy times.
Sixth, analyze the collected data through quantitative and qualitative methods as applicable. Descriptive and inferential statistics would be used to analyze extracted medical record data and summarize responses from the structured interview questionnaires. Qualitative thematic analysis of open-text interview responses may reveal further insights. Bringing both medical record review findings and interview perceptions together would provide a robust understanding of current practices and opportunities.
Seventh, develop recommendations based on the study results. Areas identified through data analysis as significantly impacting quality of pain assessment and management would be prioritized. Targeted strategies to address gaps, such as additional staff education, clinical workflow changes, use of pain assessment tools, enhancing interdisciplinary communication, and engaging patients as partners could be suggested. Implementation of recommendations would then need to be planned and evaluated for effectiveness over time through periodic re-auditing.
Disseminating the results would help spread learning to others within the hospital and field. Opportunities such as presenting at conferences, publishing in journals, sharing at grand rounds, developing educational resources, and implementing system changes organization-wide based on findings could optimize outcomes for many more patients dealing with pain. Conducting a robust pain assessment study using mixed methods as outlined here can provide valuable insights to advance care.
Carefully planning the objectives, methodology, tool development, approvals, implementation, analysis, recommendations, and dissemination is crucial for a comprehensive study to evaluate current pain practices and identify strategies to better support patients experiencing pain. Following this approach would generate reliable, meaningful evidence to guide enhancements with the goal of improving quality and outcomes for those in need of effective pain relief.