Improving Pain Medication Delivery for Fractures in the Emergency Department
Jim Sullivan, MSN, RN, CEN; Fonda Green, BSN, RN
- Sigma Affiliation
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Top Visiting Cities
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Sullivan, Jim by View
Popular Works for Sullivan, Jim by Download
Session D presented Friday, September 15, 2017
Purpose: The purpose of this project is to decrease the average time for delivery of initial pain management for patients presenting with long bone fractures.
Design: This is a leadership development project to improve provider and staff awareness through education, establishing a standardized protocol related to ordering and administering eligible pain medication, and making pain medication more accessible to providers and staff in the areas where it is being administered to patients. The emergency department triage area was modified to allow for a private visit area for providers to quickly assess patients before they are brought back to the main treatment area.
Setting: This project was implemented at a community hopsital emergency department which treats adults and pediatrics with a census of 40,000 patients yearly.
Participants/Subjects: All emergency department personnel participated in this project. This project has support from senior leadership, physician, pharmacy and nursing leadership, and emergency department charge nurses. Education and audits were conducted weekly to monitor the progress of pain medication administration. Education included the specific requirements for meeting core measures. Audits were conducted to identify providers and staff who had delays in pain medication administration with follow up on each case.
Methods: In order to decrease the amount of time for pain management in patients with long bone fractures this facility established a process to facilitate delivery of pain medication by improving access to medications and focusing on completing required documentation. The team also installed an Omnicell in the triage area and adopted changes, with continued feedback to providers keeping them apprised of ongoing monthly performance measures.
Results/Outcomes: The national recommended average time to provide pain management for patiens with long bone fractures is 54 minutes. By implementing established protocols and better accessibility to pain medications this facility was able to decrease delivery of pain medications to patients with long bone fractures from 55.4 minutes to 44.3 minutes (20% reduction).
Implications: This facility will continue to monitor performance and leverage lessons learned to improve additional throughput opportunities in the emergency deparment and the other parts of the hospital with which the emergency department interacts. As Joint Commission regularly introduces new measures it is important to educate and inform the providers of the requirements of any new measures. Pharmacy was reluctant to place an Omnicell in triage. By continuing to have discussions, devleoping a limited stock for a triage Omnicell, and granting very limited access, a level of comfort was reached in order to implement this particular change. A extremity pain control protocol was implemented to allow standing orders for nurses to administer certain pain medications when no bony deformity is present.
|Review Type||Abstract Review Only: Reviewed by Event Host|
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Showing items related by title, author, creator and subject.
Rodrigues, Heather; Granados, EricaPoster presentationSession H presented Tuesday, October 1, 2:30-3:30 pmPurpose: Integrate the use of use of integrative and multi modal therapies with patients in the emergency department to decrease the intensity of pain ...
Improving Door-to-ECG Time for Patients Presenting With Chest Pain in the Adult Emergency Department Baptiste, Diana Lyn; Maliszewski, Barbara; Gardner, Heather; Lindauer, Cathleen (2017-07-19)Purpose: The American Heart Association/ American College of Cardiology guidelines recommend rapid door-to-electrocardiography (ECG) times for patients who present with chest pain. Reducing ECG-to-door time is important ...
Dumas, Nicole; Leaming-Van Zandt, KatherineDiabetic ketoacidosis (DKA) occurs in 26% of children with new-onset type 1 diabetes and is the leading cause of morbidity and mortality in children with diabetes. For patients with DKA, the main principles of management ...
Initiative to Improve Osteoporosis Management by Adapting the Fracture Liaison Service for Outpatient Use Messerall, Tiffany; Cheese, Callie M.; King, SarahPurpose: To evaluate whether the implementation of the IOF Best Practice Framework in an outpatient women’s health clinic results in improved identification and management of post- menopausal women at risk of an osteoporotic ...
Implementation of an opioid reduction protocol utilizing alternatives for the treatment of pain in the emergency department of a level 1 trauma center Duncan, Rachael; Fry, Nancy J.; Maguire, Michelle (2017-12-04)Poster presentation Session F presented Friday, September 15, 2017 Purpose: Pain is the number one reason for emergency department visits in the United States. Many ED physicians find it quick and effective to prescribe ...