Context Matters for Nurses Leading Pain Improvement in U.S. Hospitals

Susan S. Tavernier, Jia Wen Guo, Jacqueline Eaton, Jeannine M. Brant, Patricia Berry, Susan L. Beck

    Research output: Contribution to journalArticle

    2 Citations (Scopus)

    Abstract

    Background: Pain continues to be a problem in hospitalized patients. Contextual factors contribute to the success of pain quality improvement efforts. Aims: This paper describes nurse team leaders’ perceptions of organizational context and factors perceived to help and hinder the process of leading a unit-based improvement effort focused on pain. Design: Qualitative descriptive design. Setting: Interviews took place over the telephone. Participants: Nurses from 106 hospitals across the United States. Methods: Investigators interviewed 125 nurses leading a unit-based pain quality improvement project in partnership with the National Database of Nursing Quality Indicators. Lewin's Field Theory guided a thematic analysis. Results: Key contextual factors related to the amount of change in the health care environment and characteristics of the organization and providers. Helping forces included characteristics of nurses, teamwork, a culture of quality, opportunities for learning, pain management resources, and accountability for pain management. Hindering forces included: barriers to involvement, attitudes and relationships, lack of knowledge, and types of patients. Conclusions: Overcoming the pervasive barriers of constant change and lack of staff involvement while also capitalizing on the culture of quality and characteristics of the health care team may further enhance and sustain improvement efforts related to pain management of hospitalized patients. New models for influencing quality improvement could be strengthened with involving frontline staff in both planning and implementation of improvement efforts. Clinical Implications: Because of the diverse responses, it is recommended that each unit conduct a force-field analysis to guide successful implementation of improvement efforts.

    Original languageEnglish (US)
    JournalPain Management Nursing
    DOIs
    StateAccepted/In press - Jan 1 2018

    Fingerprint

    Pain Management
    Quality Improvement
    Nurses
    Pain
    Patient Care Team
    Quality of Health Care
    Social Responsibility
    Telephone
    Nursing
    Research Personnel
    Learning
    Databases
    Interviews
    Delivery of Health Care

    ASJC Scopus subject areas

    • Advanced and Specialized Nursing

    Cite this

    Context Matters for Nurses Leading Pain Improvement in U.S. Hospitals. / Tavernier, Susan S.; Guo, Jia Wen; Eaton, Jacqueline; Brant, Jeannine M.; Berry, Patricia; Beck, Susan L.

    In: Pain Management Nursing, 01.01.2018.

    Research output: Contribution to journalArticle

    Tavernier, Susan S. ; Guo, Jia Wen ; Eaton, Jacqueline ; Brant, Jeannine M. ; Berry, Patricia ; Beck, Susan L. / Context Matters for Nurses Leading Pain Improvement in U.S. Hospitals. In: Pain Management Nursing. 2018.
    @article{f4a98a0b463b4d8b8f27aeaa104abecf,
    title = "Context Matters for Nurses Leading Pain Improvement in U.S. Hospitals",
    abstract = "Background: Pain continues to be a problem in hospitalized patients. Contextual factors contribute to the success of pain quality improvement efforts. Aims: This paper describes nurse team leaders’ perceptions of organizational context and factors perceived to help and hinder the process of leading a unit-based improvement effort focused on pain. Design: Qualitative descriptive design. Setting: Interviews took place over the telephone. Participants: Nurses from 106 hospitals across the United States. Methods: Investigators interviewed 125 nurses leading a unit-based pain quality improvement project in partnership with the National Database of Nursing Quality Indicators. Lewin's Field Theory guided a thematic analysis. Results: Key contextual factors related to the amount of change in the health care environment and characteristics of the organization and providers. Helping forces included characteristics of nurses, teamwork, a culture of quality, opportunities for learning, pain management resources, and accountability for pain management. Hindering forces included: barriers to involvement, attitudes and relationships, lack of knowledge, and types of patients. Conclusions: Overcoming the pervasive barriers of constant change and lack of staff involvement while also capitalizing on the culture of quality and characteristics of the health care team may further enhance and sustain improvement efforts related to pain management of hospitalized patients. New models for influencing quality improvement could be strengthened with involving frontline staff in both planning and implementation of improvement efforts. Clinical Implications: Because of the diverse responses, it is recommended that each unit conduct a force-field analysis to guide successful implementation of improvement efforts.",
    author = "Tavernier, {Susan S.} and Guo, {Jia Wen} and Jacqueline Eaton and Brant, {Jeannine M.} and Patricia Berry and Beck, {Susan L.}",
    year = "2018",
    month = "1",
    day = "1",
    doi = "10.1016/j.pmn.2018.05.003",
    language = "English (US)",
    journal = "Pain Management Nursing",
    issn = "1524-9042",
    publisher = "W.B. Saunders Ltd",

    }

    TY - JOUR

    T1 - Context Matters for Nurses Leading Pain Improvement in U.S. Hospitals

    AU - Tavernier, Susan S.

    AU - Guo, Jia Wen

    AU - Eaton, Jacqueline

    AU - Brant, Jeannine M.

    AU - Berry, Patricia

    AU - Beck, Susan L.

    PY - 2018/1/1

    Y1 - 2018/1/1

    N2 - Background: Pain continues to be a problem in hospitalized patients. Contextual factors contribute to the success of pain quality improvement efforts. Aims: This paper describes nurse team leaders’ perceptions of organizational context and factors perceived to help and hinder the process of leading a unit-based improvement effort focused on pain. Design: Qualitative descriptive design. Setting: Interviews took place over the telephone. Participants: Nurses from 106 hospitals across the United States. Methods: Investigators interviewed 125 nurses leading a unit-based pain quality improvement project in partnership with the National Database of Nursing Quality Indicators. Lewin's Field Theory guided a thematic analysis. Results: Key contextual factors related to the amount of change in the health care environment and characteristics of the organization and providers. Helping forces included characteristics of nurses, teamwork, a culture of quality, opportunities for learning, pain management resources, and accountability for pain management. Hindering forces included: barriers to involvement, attitudes and relationships, lack of knowledge, and types of patients. Conclusions: Overcoming the pervasive barriers of constant change and lack of staff involvement while also capitalizing on the culture of quality and characteristics of the health care team may further enhance and sustain improvement efforts related to pain management of hospitalized patients. New models for influencing quality improvement could be strengthened with involving frontline staff in both planning and implementation of improvement efforts. Clinical Implications: Because of the diverse responses, it is recommended that each unit conduct a force-field analysis to guide successful implementation of improvement efforts.

    AB - Background: Pain continues to be a problem in hospitalized patients. Contextual factors contribute to the success of pain quality improvement efforts. Aims: This paper describes nurse team leaders’ perceptions of organizational context and factors perceived to help and hinder the process of leading a unit-based improvement effort focused on pain. Design: Qualitative descriptive design. Setting: Interviews took place over the telephone. Participants: Nurses from 106 hospitals across the United States. Methods: Investigators interviewed 125 nurses leading a unit-based pain quality improvement project in partnership with the National Database of Nursing Quality Indicators. Lewin's Field Theory guided a thematic analysis. Results: Key contextual factors related to the amount of change in the health care environment and characteristics of the organization and providers. Helping forces included characteristics of nurses, teamwork, a culture of quality, opportunities for learning, pain management resources, and accountability for pain management. Hindering forces included: barriers to involvement, attitudes and relationships, lack of knowledge, and types of patients. Conclusions: Overcoming the pervasive barriers of constant change and lack of staff involvement while also capitalizing on the culture of quality and characteristics of the health care team may further enhance and sustain improvement efforts related to pain management of hospitalized patients. New models for influencing quality improvement could be strengthened with involving frontline staff in both planning and implementation of improvement efforts. Clinical Implications: Because of the diverse responses, it is recommended that each unit conduct a force-field analysis to guide successful implementation of improvement efforts.

    UR - http://www.scopus.com/inward/record.url?scp=85050870017&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=85050870017&partnerID=8YFLogxK

    U2 - 10.1016/j.pmn.2018.05.003

    DO - 10.1016/j.pmn.2018.05.003

    M3 - Article

    C2 - 30082216

    AN - SCOPUS:85050870017

    JO - Pain Management Nursing

    JF - Pain Management Nursing

    SN - 1524-9042

    ER -