BACKGROUND: Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions. OBJECTIVE: To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients. DESIGN: Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT). SETTING: One medical, 1 medical-surgical, and 1 surgical hospital unit at a large academic medical center. PARTICIPANTS: Nurses, resident physicians, patient care technicians, and unit clerks. MEASUREMENTS: Responses and ranking to the NGT question: "What causes uncontrolled pain in your unit?" RESULTS: Twenty-seven health workers generated a total of 94 ideas. The ideas perceived contributing to a suboptimal pain control were grouped as system factors (timeliness, n = 18 ideas; communication, n = 11; pain assessment, n = 8), human factors (knowledge and experience, n = 16; provider bias, n = 8; patient factors, n = 19), and interface of system and human factors (standardization, n = 14). Knowledge, timeliness, provider bias, and patient factors were the top ranked themes. CONCLUSIONS: Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context-specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers.
BACKGROUND:Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions. OBJECTIVE: To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients. DESIGN: Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT). SETTING: One medical, 1 medical-surgical, and 1 surgical hospital unit at a large academic medical center. PARTICIPANTS: Nurses, resident physicians, patient care technicians, and unit clerks. MEASUREMENTS: Responses and ranking to the NGT question: "What causes uncontrolled pain in your unit?" RESULTS: Twenty-seven health workers generated a total of 94 ideas. The ideas perceived contributing to a suboptimal pain control were grouped as system factors (timeliness, n = 18 ideas; communication, n = 11; pain assessment, n = 8), human factors (knowledge and experience, n = 16; provider bias, n = 8; patient factors, n = 19), and interface of system and human factors (standardization, n = 14). Knowledge, timeliness, provider bias, and patient factors were the top ranked themes. CONCLUSIONS: Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context-specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers.
Authors: Laura E Dreer; Christopher A Girkin; Lisa Campbell; Andy Wood; Liyan Gao; Cynthia Owsley Journal: Optom Vis Sci Date: 2013-08 Impact factor: 1.973
Authors: Betty M Kennedy; Frederick Cerise; Ronald Horswell; Willene P Griffin; Kathleen H Willis; Sarah Moody-Thomas; Jay A Besse; Peter T Katzmarzyk Journal: Clin Transl Sci Date: 2014-07-25 Impact factor: 4.689
Authors: Ian M Kronish; Shia Kent; Nathalie Moise; Daichi Shimbo; Monika M Safford; Robert E Kynerd; Ronan O'Beirne; Alexandra Sullivan; Paul Muntner Journal: J Am Soc Hypertens Date: 2017-07-06
Authors: Mary E Cooley; David F Lobach; Ellis Johns; Barbara Halpenny; Toni-Ann Saunders; Guilherme Del Fiol; Michael S Rabin; Pamela Calarese; Isidore L Berenbaum; Ken Zaner; Kathleen Finn; Donna L Berry; Janet L Abrahm Journal: J Pain Symptom Manage Date: 2013-05-13 Impact factor: 3.612
Authors: Betty M Kennedy; Sarah Moody-Thomas; Peter T Katzmarzyk; Ronald Horswell; Willene P Griffin; Mary T Coleman; Jane Herwehe; Jay A Besse; Kathleen H Willis Journal: Ochsner J Date: 2013