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The Policy-Driven Enhancement to Reduce Adult Inpatients’ Pain Intensity of “No More Than Mild Pain” During the COVID-19 Pandemic

Received: 19 September 2021    Accepted: 5 October 2021    Published: 12 October 2021
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Abstract

Context: Moderate to severe pain has a profound negative impact on functioning and quality of life, hence nursing guidelines were needed as the driving force to optimize pain nursing interventions. Aim: To enhance the reduction of adult inpatients' pain intensity of not more than mild pain during the COVID-19 pandemic nursing care settings. Methods: For this hospital-wide pain management quality improvement initiative, quarterly cross-sectional pain prevalence surveys were conducted between February 2020 and February 2021. For patients with pain scores less than 4/10 only section one of the survey questionnaires was used, while those with pain scores more than mild pain chart review was performed utilizing section two of the questionnaire. The 80/20 principle was adopted to identify the area that needs attention for specific improvement actions of each unit that achieved less than 80% of patients with pain intensity less than 4/10. Results: University Hospital A achieved an average of 92% throughout the four quarters, and 87.4% was for University Hospital B. Less than 20% of patients during the four quarters of the surveys had moderate to severe pain in both hospitals. Conclusions: Both two hospitals achieved the target goal of more than 80% pain prevalence scores of not more than mild pain during the four quarters of the studies. It is therefore strongly recommended that healthcare organizations put in place policies and procedures that assign the nurses the target goal of effective pain management.

Published in American Journal of Nursing Science (Volume 10, Issue 5)
DOI 10.11648/j.ajns.20211005.14
Page(s) 237-243
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Policies and Procedures, Pain Intensity, No Pain, Mild Pain

References
[1] McDermid, J, C., Donner, A., Richards, R. S., & Roth, J. H. (2002). Patient versus injury factors as predictors of pain and disability six months after a distal radius fracture. Journal of Clinical Epidemiology, 55, 849-854.
[2] Raja, S. N., Carr, D. B., Cohen, M., Finnerup, N. B., Flor, H., Gibson, S., Keefe, F. J., Mogil, J. S., Ringkamp, M. & Sluka, K. A. J. P. (2020). The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. 161, 1976-1982.
[3] Malik, N. A. J. A., Pain & Care, I. (2020). Revised definition of pain by ‘International Association for the Study of Pain’: Concepts, challenges and compromises. 24, 481-483.
[4] Cohen, M., Quintner, J., & Van Rysewyk, S. J. P. R. (2018). Reconsidering the International Association for the Study of Pain definition of pain. 3.
[5] Tesarz, J., & Eich, W. J. P. (2017). A conceptual framework for “updating the definition of pain”. 158, 1177-1178.
[6] Adem, A. O., Obsa, M. S., Worji, T. A. J. I. J. O. M., & Sciences, M. (2017). Assessments of health professionals’ knowledge towards post-operative pain management in Asella Teaching and Referral Hospital, South East Ethiopia. 9, 137-141.
[7] Carragee, E. J. & Cheng, I. J. T. S. J. (2010). Minimum acceptable outcomes after lumbar spinal fusion. 10, 313-320.
[8] Vitullo, M. (2020). The Clinically Aligned Pain Assessment Tool (CAPA) Evidenced-Based Change Project-Benchmark Study.
[9] Kang, Y., & Demiris, G. J. I. J. O. O. P. N. (2018). Self-report pain assessment tools for cognitively intact older adults: Integrative review. 13, e12170.
[10] Booker, S. Q., Herr, K. A., & Horgas, A. L. J. P. M. N. (2020). A paradigm shift for movement-based pain assessment in older adults: Practice, policy and regulatory drivers.
[11] Varndell, W., Fry, M., & Elliot, D. J. J. O. C. N. (2017). A systematic review of observational pain assessment instruments for use with nonverbal intubated critically ill adult patients in the emergency department: an assessment of their suitability and psychometric properties. 26, 7-32.
[12] Myles, P., Myles, D., Galagher, W., Boyd, D., Chew, C., Macdonald, N. & Dennis, A. J. B. B. J. O. A. 2017. Measuring acute postoperative pain using the visual analog scale: the minimal clinically important difference and patient acceptable symptom state. 118, 424-429.
[13] Jumbo, S. U., Macdermid, J. C., Packham, T. L., Athwal, G. S., Faber, K. J. J. H., & Outcomes, Q. O. L. (2020). Reproducibility: reliability and agreement parameters of the Revised Short McGill Pain Questionnaire Version-2 for use in patients with musculoskeletal shoulder pain. 18, 1-12.
[14] Treede, R.-D., Rief, W., Barke, A., Aziz, Q., Bennett, M. I., Benoliel, R., Cohen, M., Evers, S., Finnerup, N. B., & First, M. B. J. P. (2019). Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). 160, 19-27.
[15] Higgins, C., Smith, B. & Matthews, K. J. B. J. O. A. (2019). Evidence of opioid-induced hyperalgesia in clinical populations after chronic opioid exposure: a systematic review and meta-analysis. 122, e114-e126.
[16] Taylor, E. M., Boyer, K., Campbell, F. A. J. P. R., & Management (2008). Pain in hospitalized children: a prospective cross-sectional survey of pain prevalence, intensity, assessment and management in a Canadian pediatric teaching hospital. 13, 25-32.
[17] Crellin, D. J., Harrisson, D., Sanstamaria, N., Huoque, H., & Babl, F. E. J. T. J. O. P. (2018). The psychometric properties of the FLACC scale used to assess procedural pain. 19, 862-872.
[18] Tsze, D. S., Hirschfeld, G., Dayan, P. S., Bulloch, B., & Von Baeyer, C. L. J. P. E. C. (2018). Defining no pain, mild, moderate, and severe pain based on the Faces Pain Scale–Revised and Color Analog Scale in children with acute pain. 34, 537.
[19] Karcioglu, O., Topacoglu, H., Dikme, O., & Dikme, O. J. T. A. J. O. E. M. (2018). A systematic review of the pain scales in adults: which to use? 36, 707-714.
[20] Clauw, D. J., Hȁuser, W., Cohen, S. P., & Fitzcharles, M.-A. J. P. (2020). Considering the potential for an increase in chronic pain after the COVID-19 pandemic. 161, 1694.
[21] Miro, J., De La Vega, R., Sole, E., Racine, M., Jensen, M. P., Galan, S., Engel, J. M. J. D. & Rehabilitation. (2017). Defining mild, moderate, and severe pain in young people with physical disabilities. 39, 1131-1135.
[22] Williams, E. S., Savage, G. T., Patrician, P. A. J. I. T. H. C. M. B., MA: Jones & Learning B., (2017). Quality Improvement Basics.
[23] Mullennix, S. C., Iseler, J., Kwiatkowski, G. M., Mccann-Spry, L., Skinner, J., Kuhl, N., Vandepol, E. K., & Poland, C. A. J. C. N. S. (2020). A clinical nurse specialist-led emergency department naloxone distribution program. 34, 116-123.
[24] Oakes, L. L., Anghelescu, D. L., Windsor, K. B., Barnhill, P. D. J. J. O. P., & Management, S. (2008). An institutional quality improvement initiative for pain management for pediatric cancer inpatients. 35, 656-669.
[25] Meissner, W., Huygen, F., Neugebauer, E. A., Osterbrink, J., Benhamou, D., Betteridge, N., Coluzzi, F., De Andres, J., Fawcett, W., Fletcher, D. J. C. M. R., & Opinion (2018). Management of acute pain in the postoperative setting: the importance of quality indicators. 34, 187-196.
Cite This Article
  • APA Style

    Litaba Efraim Kolobe, Nabeeha Tashkandi, Angela Tracy Caswell, Sheikha Al Anizi, Aisha Al Khanbaie, et al. (2021). The Policy-Driven Enhancement to Reduce Adult Inpatients’ Pain Intensity of “No More Than Mild Pain” During the COVID-19 Pandemic. American Journal of Nursing Science, 10(5), 237-243. https://doi.org/10.11648/j.ajns.20211005.14

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    ACS Style

    Litaba Efraim Kolobe; Nabeeha Tashkandi; Angela Tracy Caswell; Sheikha Al Anizi; Aisha Al Khanbaie, et al. The Policy-Driven Enhancement to Reduce Adult Inpatients’ Pain Intensity of “No More Than Mild Pain” During the COVID-19 Pandemic. Am. J. Nurs. Sci. 2021, 10(5), 237-243. doi: 10.11648/j.ajns.20211005.14

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    AMA Style

    Litaba Efraim Kolobe, Nabeeha Tashkandi, Angela Tracy Caswell, Sheikha Al Anizi, Aisha Al Khanbaie, et al. The Policy-Driven Enhancement to Reduce Adult Inpatients’ Pain Intensity of “No More Than Mild Pain” During the COVID-19 Pandemic. Am J Nurs Sci. 2021;10(5):237-243. doi: 10.11648/j.ajns.20211005.14

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  • @article{10.11648/j.ajns.20211005.14,
      author = {Litaba Efraim Kolobe and Nabeeha Tashkandi and Angela Tracy Caswell and Sheikha Al Anizi and Aisha Al Khanbaie and Waad Maringah and Kawther Ajarmeh and Eman Al Ruwaili},
      title = {The Policy-Driven Enhancement to Reduce Adult Inpatients’ Pain Intensity of “No More Than Mild Pain” During the COVID-19 Pandemic},
      journal = {American Journal of Nursing Science},
      volume = {10},
      number = {5},
      pages = {237-243},
      doi = {10.11648/j.ajns.20211005.14},
      url = {https://doi.org/10.11648/j.ajns.20211005.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20211005.14},
      abstract = {Context: Moderate to severe pain has a profound negative impact on functioning and quality of life, hence nursing guidelines were needed as the driving force to optimize pain nursing interventions. Aim: To enhance the reduction of adult inpatients' pain intensity of not more than mild pain during the COVID-19 pandemic nursing care settings. Methods: For this hospital-wide pain management quality improvement initiative, quarterly cross-sectional pain prevalence surveys were conducted between February 2020 and February 2021. For patients with pain scores less than 4/10 only section one of the survey questionnaires was used, while those with pain scores more than mild pain chart review was performed utilizing section two of the questionnaire. The 80/20 principle was adopted to identify the area that needs attention for specific improvement actions of each unit that achieved less than 80% of patients with pain intensity less than 4/10. Results: University Hospital A achieved an average of 92% throughout the four quarters, and 87.4% was for University Hospital B. Less than 20% of patients during the four quarters of the surveys had moderate to severe pain in both hospitals. Conclusions: Both two hospitals achieved the target goal of more than 80% pain prevalence scores of not more than mild pain during the four quarters of the studies. It is therefore strongly recommended that healthcare organizations put in place policies and procedures that assign the nurses the target goal of effective pain management.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - The Policy-Driven Enhancement to Reduce Adult Inpatients’ Pain Intensity of “No More Than Mild Pain” During the COVID-19 Pandemic
    AU  - Litaba Efraim Kolobe
    AU  - Nabeeha Tashkandi
    AU  - Angela Tracy Caswell
    AU  - Sheikha Al Anizi
    AU  - Aisha Al Khanbaie
    AU  - Waad Maringah
    AU  - Kawther Ajarmeh
    AU  - Eman Al Ruwaili
    Y1  - 2021/10/12
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ajns.20211005.14
    DO  - 10.11648/j.ajns.20211005.14
    T2  - American Journal of Nursing Science
    JF  - American Journal of Nursing Science
    JO  - American Journal of Nursing Science
    SP  - 237
    EP  - 243
    PB  - Science Publishing Group
    SN  - 2328-5753
    UR  - https://doi.org/10.11648/j.ajns.20211005.14
    AB  - Context: Moderate to severe pain has a profound negative impact on functioning and quality of life, hence nursing guidelines were needed as the driving force to optimize pain nursing interventions. Aim: To enhance the reduction of adult inpatients' pain intensity of not more than mild pain during the COVID-19 pandemic nursing care settings. Methods: For this hospital-wide pain management quality improvement initiative, quarterly cross-sectional pain prevalence surveys were conducted between February 2020 and February 2021. For patients with pain scores less than 4/10 only section one of the survey questionnaires was used, while those with pain scores more than mild pain chart review was performed utilizing section two of the questionnaire. The 80/20 principle was adopted to identify the area that needs attention for specific improvement actions of each unit that achieved less than 80% of patients with pain intensity less than 4/10. Results: University Hospital A achieved an average of 92% throughout the four quarters, and 87.4% was for University Hospital B. Less than 20% of patients during the four quarters of the surveys had moderate to severe pain in both hospitals. Conclusions: Both two hospitals achieved the target goal of more than 80% pain prevalence scores of not more than mild pain during the four quarters of the studies. It is therefore strongly recommended that healthcare organizations put in place policies and procedures that assign the nurses the target goal of effective pain management.
    VL  - 10
    IS  - 5
    ER  - 

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Author Information
  • Department of Nursing Pain Management, King Abdulaziz Medical City Hospital, Riyadh, Saudi Arabia

  • Department of Nursing Administration, King Abdulaziz Medical City Hospital, Riyadh, Saudi Arabia

  • Department of Nursing Administration, King Abdullah Specialised Children’s Hospital, Riyadh, Saudi Arabia

  • Department of Nursing Pain Management, King Abdullah Specialised Children’s Hospital, Riyadh, Saudi Arabia

  • Department of Nursing Pain Management, King Abdulaziz Medical City Hospital, Riyadh, Saudi Arabia

  • Department of Nursing Pain Management, King Abdulaziz Medical City Hospital, Riyadh, Saudi Arabia

  • Department of Nursing Pain Management, King Abdulaziz Medical City Hospital, Riyadh, Saudi Arabia

  • Department of Nursing Pain Management, King Abdullah Specialised Children’s Hospital, Riyadh, Saudi Arabia

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