A nurse-initiated pain protocol in the ED improves pain treatment in patients with acute musculoskeletal pain

Jorien Pierik, Sivera A. Berben, Maarten Joost IJzerman, Menno I. Gaakeer, Fred L. Eenennaam, Arie B. van Vugt, Catharina Jacoba Maria Doggen

Research output: Contribution to journalArticleAcademicpeer-review

13 Citations (Scopus)

Abstract

While acute musculoskeletal pain is a frequent complaint, its management is often neglected. An implementation of a nurse-initiated pain protocol based on the algorithm of a Dutch pain management guideline in the emergency department might improve this. A pre–post intervention study was performed as part of the prospective PROTACT follow-up study. During the pre- (15 months, n = 504) and post-period (6 months, n = 156) patients' self-reported pain intensity and pain treatment were registered. Analgesic provision in patients with moderate to severe pain (NRS ≥4) improved from 46.8% to 68.0%. Over 10% of the patients refused analgesics, resulting into an actual analgesic administration increase from 36.3% to 46.1%. Median time to analgesic decreased from 10 to 7 min (P < 0.05), whereas time to opioids decreased from 37 to 15 min (P < 0.01). Mean pain relief significantly increased to 1.56 NRS-points, in patients who received analgesic treatment even up to 2.02 points. The protocol appeared to lead to an increase in analgesic administration, shorter time to analgesics and a higher clinically relevant pain relief. Despite improvements, suffering moderate to severe pain at ED discharge was still common. Protocol adherence needs to be studied in order to optimize pain management.
Original languageEnglish
Pages (from-to)3-10
Number of pages8
JournalInternational emergency nursing
Volume27
DOIs
Publication statusPublished - 8 Mar 2016

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Musculoskeletal Pain
Acute Pain
Analgesics
Nurses
Pain
Pain Management
Therapeutics
Opioid Analgesics
Hospital Emergency Service
Guidelines

Keywords

  • METIS-316261
  • IR-100073

Cite this

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title = "A nurse-initiated pain protocol in the ED improves pain treatment in patients with acute musculoskeletal pain",
abstract = "While acute musculoskeletal pain is a frequent complaint, its management is often neglected. An implementation of a nurse-initiated pain protocol based on the algorithm of a Dutch pain management guideline in the emergency department might improve this. A pre–post intervention study was performed as part of the prospective PROTACT follow-up study. During the pre- (15 months, n = 504) and post-period (6 months, n = 156) patients' self-reported pain intensity and pain treatment were registered. Analgesic provision in patients with moderate to severe pain (NRS ≥4) improved from 46.8{\%} to 68.0{\%}. Over 10{\%} of the patients refused analgesics, resulting into an actual analgesic administration increase from 36.3{\%} to 46.1{\%}. Median time to analgesic decreased from 10 to 7 min (P < 0.05), whereas time to opioids decreased from 37 to 15 min (P < 0.01). Mean pain relief significantly increased to 1.56 NRS-points, in patients who received analgesic treatment even up to 2.02 points. The protocol appeared to lead to an increase in analgesic administration, shorter time to analgesics and a higher clinically relevant pain relief. Despite improvements, suffering moderate to severe pain at ED discharge was still common. Protocol adherence needs to be studied in order to optimize pain management.",
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A nurse-initiated pain protocol in the ED improves pain treatment in patients with acute musculoskeletal pain. / Pierik, Jorien; Berben, Sivera A.; IJzerman, Maarten Joost; Gaakeer, Menno I.; Eenennaam, Fred L.; van Vugt, Arie B.; Doggen, Catharina Jacoba Maria.

In: International emergency nursing, Vol. 27, 08.03.2016, p. 3-10.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - A nurse-initiated pain protocol in the ED improves pain treatment in patients with acute musculoskeletal pain

AU - Pierik, Jorien

AU - Berben, Sivera A.

AU - IJzerman, Maarten Joost

AU - Gaakeer, Menno I.

AU - Eenennaam, Fred L.

AU - van Vugt, Arie B.

AU - Doggen, Catharina Jacoba Maria

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