Implementing national standards for cancer pain management: Program model and evaluation

• Published in: Journal of pain and symptom management Vol. 12; no. 6; pp. 334 - 347
• Main Authors: Bookbinder, Marilyn, Covle, Nessa, Kiss, Margaret, Goldstein, Mary Layman, Holritz, Karen, Thaler, Howard, Gianella, Alice, Derby, Susan, Brown, Mary, Racolin, Angela, Ho, May Nah, Portenoy, Russell K.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.1996
• Subjects: cancer pain management; continuous quality improvement; Evaluation Studies as Topic; Female; Humans; Male; Middle Aged; Models, Organizational; Neoplasms - complications; Pain, Intractable - drug therapy; Pain, Intractable - etiology; Pain, Intractable - therapy; Palliative Care - standards; Quality assurance standards; Quality Assurance, Health Care; cancer pain management; continuous quality improvement; Quality assurance standards
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/S0885-3924(96)00204-7

The purpose of this quasi-experimental (pre- and posttest) study was to test a model pain management program (PMP) to implement the American Pain Society (APS) quality assurance standards for the management of acute and chronic cancer pain using a continuous quality improvement (CQJ) approach to improve professionals' knowledge and skills, patient satisfaction, and to identify areas needing improvement. The sample consisted of 1210 nurse responses and 698 interviews of patients with pain during hospitalization at a major urban cancer center. The PMP provided a structure (standards), educational opportunities, and training in CQI methods. Outcome measures included a patient evaluation questionnaire and concerns checklist: nurse knowledge, attitude and barriers questionnaire; and focus groups to identify areas needing improvement. Significant improvements were found in patients' satisfaction, nurses' knowledge and attitude scores, and reductions in nurses' perceptions of barriers. Focus groups revealed the need for improved communication among disciplines about pain and better assessment of patients unable to self-report. The program met its goal of implementing the APS standards, educating nurses, and identifying “system” problems, and improving overall patient satisfaction.