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.
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.
Authors: Melanie Regan; Eli Ristevski; Rebecca Jones; Sibilah Breen; Allison Hartney Journal: Support Care Cancer Date: 2011-01-06 Impact factor: 3.603
Authors: Keela Herr; Marita Titler; Perry G Fine; Sara Sanders; Joseph E Cavanaugh; John Swegle; Xiongwen Tang; Chris Forcucci Journal: Pain Med Date: 2012-07-03 Impact factor: 3.750
Authors: Bernadette Bea Brown; Jane Young; David P Smith; Andrew B Kneebone; Andrew J Brooks; Miranda Xhilaga; Amanda Dominello; Dianne L O'Connell; Mary Haines Journal: Implement Sci Date: 2014-05-29 Impact factor: 7.327
Authors: Tim Luckett; Jane Phillips; Meera Agar; Lawrence Lam; Patricia M Davidson; Nicola McCaffrey; Frances Boyle; Tim Shaw; David C Currow; Alison Read; Annmarie Hosie; Melanie Lovell Journal: BMC Health Serv Res Date: 2018-07-16 Impact factor: 2.655