Implementation of Pain Management Program in Oncology and Medical Ward

By MOK Wing Sze, Mary, RN, BscN, MN, 20/F Nursing Department

Purpose

Knowledge gap exits as not all the nurses in Oncology and medical ward received training in cancer pain management.  Moreover, there is lack of standard practice in pain assessment and its documentation.  This pilot study is designed to improve nurses’ self-perceived knowledge and attitude about cancer pain management; and also to improve nurses’ practice in pain assessment and documentation.

Background

Pain is a common and significant problem for cancer patients.  It affects the quality of life of patients by impacting their physical, social and psychological functioning.  Timely and effective pain relief is essential for optimal patient outcomes. Studies have found that nurses’ inadequate knowledge and their negative attitude as well as inadequate pain assessment are the barriers to optimal pain control.

Methods

In this study, a pain management program was implemented to educate nurses who work in oncology and medical ward on cancer pain management; and to standardized practice in pain assessment and documentation.  A pre and post 5-point Likert scale was used to reflect nurses’ self-perceived knowledge and practice in pain management.  Audit was performed pre and post implementation of standardized pain assessment and documentation practice.

Results

Nurses’ self-perception on their practice in pain assessment and documentation is improved.  After a two weeks trial period on standardized pain assessment form.  The documentation rate of pain assessment before regular pain medication administration and documentation of pain re-assessment rate improved by 56% and 36% respectively.  There is a 63% improvement in documentation for pain assessment for pain assessment before PRN pain medication administration and a 51% improvement in documenting pain re-assessment for PRN pain medication.

Discussion

The standardized practice is essential in nursing and health care.  The next steps are to extend the pilot study of using standardized pain assessment form to other patient populations on the same ward and continue to seek feedback from the nurses on the pilot standardized pain assessment form to ensure the sustainability on the new practice.