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Contextual Factors Impacting a Pain Management Intervention
Author(s) -
Alaloul Fawwaz,
Williams Kimberly,
Myers John,
Jones Kayla Dlauren,
Sullivan Katelyn,
Logsdon M. Cynthia
Publication year - 2017
Publication title -
journal of nursing scholarship
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.009
H-Index - 80
eISSN - 1547-5069
pISSN - 1527-6546
DOI - 10.1111/jnu.12319
Subject(s) - intervention (counseling) , medicine , nursing , pain management , patient satisfaction , physical therapy , health care , family medicine , psychology , economics , economic growth
Abstract Purpose To determine if findings from our preliminary study related to patient and nursing satisfaction with a pain management intervention could be replicated in a changed environment, and if contextual factors could impact the effectiveness of a pain management intervention on patient satisfaction with nursing staff's management of pain. Methods A prospective, experimental design was used with six monthly assessments before, during, and after the intervention. Data were collected from 540 patients admitted to eight medical surgical and progressive care units and nurses that worked in these units at an academic health sciences center in the southern United States, from March to July 2015. The script‐based, pain management communication intervention included three specific tactics: script‐based communication, use of white boards, and hourly rounding. The Hospital Consumer Assessment of Healthcare Providers and Systems survey was used to assess two items: “pain is well controlled” and “staff did everything they could to help with pain.” Contextual factors focused on the practice setting. Findings Both scores for “pain is well controlled” (β = .028, p = 0.651) and scores for “staff did everything they could to help with pain” (β = .057, p = .385) did not change initially but then increased significantly and were sustained over time. Nurses had high levels of satisfaction with the intervention ( M = 7.9, SD = 2.1) and compliance with the intervention ( M = 8.0, SD = 1.9), and had little difficulty in implementing the intervention ( M = 8.3, SD = 1.4). In terms of contextual factors, the number of beds on the unit and the number of patients being discharged negatively impacted scores for “pain is well controlled” and “staff did everything they could to help with pain.” Hospital length of stay positively impacted scores for “pain is well controlled” by staff. Conclusions Despite challenging contextual variables, the study extended the findings of an early preliminary study in showing the effectiveness of pain management intervention on patient satisfaction with staff's management of pain. In evaluating the impact of an intervention, it is essential to examine the contextual environment. Clinical Relevance Using simple, clear, and consistent communication between patients and nurses related to pain can positively impact patient satisfaction with pain management over time. The health care environment can enhance nursing practice and patients’ outcomes.