Can just-in-time, evidence-based "reminders" improve pain management among home health care nurses and their patients?

Abstract:

:The purpose of this randomized, controlled, home care intervention was to test the effectiveness of two nurse-targeted, e-mail-based interventions to increase home care nurses' adherence to pain assessment and management guidelines, and to improve patient outcomes. Nurses from a large urban non-profit home care organization were assigned to usual care or one of two interventions upon identification of an eligible cancer patient with pain. The basic intervention consisted of a patient-specific, one-time e-mail reminder highlighting six pain-specific clinical recommendations. The augmented intervention supplemented the initial e-mail reminder with provider prompts, patient education material, and clinical nurse specialist outreach. Over 300 nurses were randomized and outcomes of 673 of their patients were reviewed. Data collection involved clinical record abstraction of nurse care practices and patient interviews completed approximately 45 days after start of care. The intervention had limited effect on nurse-documented care practices but patient outcomes were positively influenced. Patients in the augmented group improved significantly over the control group in ratings of pain intensity at its worst, whereas patients in the basic group had better ratings of pain intensity on average. Other outcomes measures were also positively influenced but did not reach statistical significance. Our findings suggest that although reminders have some role in improving cancer pain management, a more intensive approach is needed for a generalized nursing workforce with limited recent exposure to state-of-the-art pain management practices.

journal_name

J Pain Symptom Manage

authors

McDonald MV,Pezzin LE,Feldman PH,Murtaugh CM,Peng TR

doi

10.1016/j.jpainsymman.2004.08.018

subject

Has Abstract

pub_date

2005-05-01 00:00:00

pages

474-88

issue

5

eissn

0885-3924

issn

1873-6513

pii

S0885-3924(05)00134-X

journal_volume

29

pub_type

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