Staff at High Pointe Surgery Center in Lake Elmo, Minn., knew they had to revamp their pain control protocols when less than 90% of their patients were satisfied with how their pain was addressed and managed. In 2010, the center’s newly formed “pain team” was charged with bringing pain control satisfaction scores above the 94% national average. They looked at improving every factor that contributed to controlling patients’ discomfort: how pain varied by procedure, length of surgery, patients’ expectations and types of intervention used.
“Educating patients before surgery won’t change the pain they experience,” says Diane Lulic, RN, High Pointe’s pre- and post-op nurse manager, “but it will set their expectations at realistic levels.” Ms. Lulic helped develop a letter for patients and their families that discusses post-op pain and the steps they can take at home to help control discomfort: rest, elevation and consistently taking pain medications.
High Pointe developed specific medication directives that match patients’ pain experiences and expectations. “They’d administer morphine, Dilaudid or fentanyl — there was no consistency,” explains Ms. Lulic. Nurses now know to give patients in moderate discomfort a certain type of medication and assess its efficacy before moving on to the next and more aggressive step in the facility’s pain-control algorithm.
The improvements worked. In the first 4 months of 2011, High Pointe’s overall patient satisfaction scores with respect to pain control improved to 95%, above the national average.