Can just-in-time, evidence-based "reminders" improve pain management among home health care nurses and their patients? J Pain Symptom Manage 2005 May;29(5):474-88
Date
05/21/2005Pubmed ID
15904750DOI
10.1016/j.jpainsymman.2004.08.018Scopus ID
2-s2.0-19444370037 (requires institutional sign-in at Scopus site) 32 CitationsAbstract
The purpose of this randomized, controlled, home care intervention was to test the effectiveness of two nurse-targeted, e-mail-based interventions to increase home care nurses' adherence to pain assessment and management guidelines, and to improve patient outcomes. Nurses from a large urban non-profit home care organization were assigned to usual care or one of two interventions upon identification of an eligible cancer patient with pain. The basic intervention consisted of a patient-specific, one-time e-mail reminder highlighting six pain-specific clinical recommendations. The augmented intervention supplemented the initial e-mail reminder with provider prompts, patient education material, and clinical nurse specialist outreach. Over 300 nurses were randomized and outcomes of 673 of their patients were reviewed. Data collection involved clinical record abstraction of nurse care practices and patient interviews completed approximately 45 days after start of care. The intervention had limited effect on nurse-documented care practices but patient outcomes were positively influenced. Patients in the augmented group improved significantly over the control group in ratings of pain intensity at its worst, whereas patients in the basic group had better ratings of pain intensity on average. Other outcomes measures were also positively influenced but did not reach statistical significance. Our findings suggest that although reminders have some role in improving cancer pain management, a more intensive approach is needed for a generalized nursing workforce with limited recent exposure to state-of-the-art pain management practices.
Author List
McDonald MV, Pezzin LE, Feldman PH, Murtaugh CM, Peng TRAuthor
Liliana Pezzin PhD, JD Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Evidence-Based Medicine
Female
Home Care Services
Humans
Internet
Male
Middle Aged
Nurses
Palliative Care
Patients
Reminder Systems
Time Factors
