Raniah N Aldekhyyel1,2, Genevieve B Melton1,3, Bruce Lindgren4, Yan Wang1, Michael B Pitt5. 1. Institute for Health Informatics, and. 2. MIELU, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 3. Departments of Surgery and. 4. Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota; and. 5. Pediatrics, mbpitt@umn.edu.
Abstract
OBJECTIVES: Implement a novel pain-management interface that is used to bring real-time, patient-reported pain assessments to the inpatient television and evaluate the impact of implementation on the pain-management clinical workflow, patient engagement, and nursing pain reassessments. METHODS: We developed a pain-management tool interfacing 4 stand-alone technologies: a television-based, interactive patient care system; electronic health record system; nursing call system; and pharmacy inventory-management system. The workflow is triggered when pain medications are dispensed by sending an automatic pain assessment rating question via the patient's television at a predefined time. To measure the effects of implementation, we calculated patient and/or parent use rates and pain reassessment timely documentation rates. Data were extracted from the electronic health record for a period of 22 months and covered pre- and postimplementation. RESULTS: A total of 56 931 patient records were identified during the study period, representing 2447 unique patients. In total, 608 parents and/or patients reported their pain through the tool. Use rates were 6.5% for responding to the pain rating prompt and 13.3% for the follow-up prompt, in which additional nonpharmacologic strategies to eliminate pain were offered. A modest increase was found in the mean timely documentation rates on the basis of nursing documentation standards (26.1% vs 32.8%, a percentage increase of 25.7%; P < .001) along with decreased median time to pain reassessment documentation (29 minutes versus 25 minutes, a percentage decrease of 13.8%; P < .001). CONCLUSIONS: With this novel tool, we offer a potentially scalable approach in supporting the pain-management clinical workflow, integration of technologies, and promoting of patient and/or parent engagement in the inpatient setting.
OBJECTIVES: Implement a novel pain-management interface that is used to bring real-time, patient-reported pain assessments to the inpatient television and evaluate the impact of implementation on the pain-management clinical workflow, patient engagement, and nursing pain reassessments. METHODS: We developed a pain-management tool interfacing 4 stand-alone technologies: a television-based, interactive patient care system; electronic health record system; nursing call system; and pharmacy inventory-management system. The workflow is triggered when pain medications are dispensed by sending an automatic pain assessment rating question via the patient's television at a predefined time. To measure the effects of implementation, we calculated patient and/or parent use rates and pain reassessment timely documentation rates. Data were extracted from the electronic health record for a period of 22 months and covered pre- and postimplementation. RESULTS: A total of 56 931 patient records were identified during the study period, representing 2447 unique patients. In total, 608 parents and/or patients reported their pain through the tool. Use rates were 6.5% for responding to the pain rating prompt and 13.3% for the follow-up prompt, in which additional nonpharmacologic strategies to eliminate pain were offered. A modest increase was found in the mean timely documentation rates on the basis of nursing documentation standards (26.1% vs 32.8%, a percentage increase of 25.7%; P < .001) along with decreased median time to pain reassessment documentation (29 minutes versus 25 minutes, a percentage decrease of 13.8%; P < .001). CONCLUSIONS: With this novel tool, we offer a potentially scalable approach in supporting the pain-management clinical workflow, integration of technologies, and promoting of patient and/or parent engagement in the inpatient setting.
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