Implementation of cancer pain guidelines by acute care nurse practitioners using an audit and feedback strategy Journal Article

Authors: Dulko, D.; Hertz, E.; Julien, J.; Beck, S.; Mooney, K.
Article Title: Implementation of cancer pain guidelines by acute care nurse practitioners using an audit and feedback strategy
Abstract: Purpose: Despite the availability of clinical practice guidelines (CPGs) for cancer pain, consistent integration of these principles into practice has not been achieved. The optimal method for implementing CPGs and the impact of guidelines on healthcare outcomes remain uncertain. This study evaluated the effect of an audit and feedback (A/F) intervention on nurse practitioner (NP) implementation of cancer pain CPGs and on hospitalized patients' self-report of pain and satisfaction with pain relief. Data sources: Eight NPs and two groups of 96 patients were the sources of data. Eligible patients in both groups completed the Brief Pain Inventory-Short Form (BPI-SF) within 24 h of admission and every 48 h until discharge. During A/F, NPs received weekly feedback on pain scores and guideline adherence. Conclusions: Nurse practitioner adherence to CPGs increased during A/F. Pain intensity did not significantly differ between groups. Intervention group patients reported significantly less overall pain interference (p <.0001), interference with general activity (p =.0003), and sleep (p =.006 Satisfaction with pain relief increased from 68.4% to 95.1% during A/F (p <.0001 Implications for practice: A/F is an effective strategy to promote CPG use. Improved functional status in the absence of decreased pain severity underscores the need to consider symptom clusters when studying pain. © 2010 American Academy of Nurse Practitioners.
Keywords: adult; controlled study; aged; aged, 80 and over; middle aged; patient satisfaction; clinical trial; neoplasm; nursing; organization and management; neoplasms; controlled clinical trial; pain; evidence-based practice; practice guideline; oncology; adaptive behavior; psychological aspect; education; practice guidelines as topic; hospital patient; education, nursing, continuing; pain measurement; guideline adherence; analysis of variance; pain assessment; pain management; single blind procedure; single-blind method; nurse practitioner; nursing education; nurse practitioners; clinical practice guidelines (cpgs); nursing evaluation research; feedback, psychological; inpatients; nursing audit
Journal Title: Journal of the American Academy of Nurse Practitioners
Volume: 22
Issue: 1
ISSN: 1041-2972
Publisher: Wiley Blackwell  
Date Published: 2010-01-01
Start Page: 45
End Page: 55
Language: English
DOI: 10.1111/j.1745-7599.2009.00469.x
PUBMED: 20074196
PROVIDER: scopus
Notes: --- - "Export Date: 20 April 2011" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Elisheva Hertz
    5 Hertz