Dissemination and Implementation of Patient-centered Indicators of Pain Care Quality and Outcomes

Susan L. Beck, Nancy Dunton, Patricia Berry, Jeannine M. Brant, Jia Wen Guo, Catima Potter, Beth Spornitz, Jacqueline Eaton, Bob Wong

    Research output: Contribution to journalArticle

    1 Citation (Scopus)

    Abstract

    Background: Previous approaches to measuring and improving nursing-sensitive, patient-centered metrics of pain quality and outcomes in hospitalized patients have been limited. Methods: In this translational research study, we disseminated and implemented pain quality indicators in 1611 medical and/or surgical, step-down, rehabilitation, critical access, and obstetrical (postpartum) units from 326 US hospitals participating in the National Database of Nursing Quality Indicators. Eligible patients were English-speaking adults in pain. Trained nurses collected patients' perceptions via structured interview including 9 pain quality indicators, demographic, and clinical variables; these patient experience data were merged with unit and hospital level data. Analyses included geographic mapping; summary statistics and 3-level mixed effects modeling. Results: Hospitals in 45 states and District of Columbia participated. Of 22,293 screened patients, 15,012 were eligible; 82% verbally consented and participated. Pain prevalence was 72%. Participants were 59.4% female; ages ranged from 19 to 90+ (median: 59 y); 27.3% were nonwhite and 6.5% were Hispanic. Pain intensity on average over the past 24 hours was 6.03 (SD = 2.45) on a 0-10 scale. 28.5% of patients were in severe pain frequently or constantly. Race (nonwhite), younger age, being female and nonsurgical were associated (P < 0.001) with greater pain. Care quality indicators ranking lowest related to discussion of analgesic side effects and use of nonpharmacologic approaches. Conclusions: Unrelieved pain remains a high-volume problem. Individual factors and unit type were significantly associated with pain outcomes. Hospitals can employ these quality indicators to direct continuous quality improvement targeting pain care quality.

    Original languageEnglish (US)
    JournalMedical Care
    DOIs
    StateAccepted/In press - Jan 1 2018

    Fingerprint

    Quality of Health Care
    Pain
    Geographic Mapping
    Patient-Centered Care
    Hospital Units
    Translational Medical Research
    Quality Improvement
    Hispanic Americans
    Postpartum Period
    Analgesics
    Nursing
    Rehabilitation
    Nurses
    Demography
    Databases
    Interviews

    Keywords

    • dissemination and implementation
    • hospitals
    • nursing
    • pain
    • patient experience
    • quality indicators

    ASJC Scopus subject areas

    • Public Health, Environmental and Occupational Health

    Cite this

    Dissemination and Implementation of Patient-centered Indicators of Pain Care Quality and Outcomes. / Beck, Susan L.; Dunton, Nancy; Berry, Patricia; Brant, Jeannine M.; Guo, Jia Wen; Potter, Catima; Spornitz, Beth; Eaton, Jacqueline; Wong, Bob.

    In: Medical Care, 01.01.2018.

    Research output: Contribution to journalArticle

    Beck, Susan L. ; Dunton, Nancy ; Berry, Patricia ; Brant, Jeannine M. ; Guo, Jia Wen ; Potter, Catima ; Spornitz, Beth ; Eaton, Jacqueline ; Wong, Bob. / Dissemination and Implementation of Patient-centered Indicators of Pain Care Quality and Outcomes. In: Medical Care. 2018.
    @article{b351b407e97144cda9b9d448cc63f5ab,
    title = "Dissemination and Implementation of Patient-centered Indicators of Pain Care Quality and Outcomes",
    abstract = "Background: Previous approaches to measuring and improving nursing-sensitive, patient-centered metrics of pain quality and outcomes in hospitalized patients have been limited. Methods: In this translational research study, we disseminated and implemented pain quality indicators in 1611 medical and/or surgical, step-down, rehabilitation, critical access, and obstetrical (postpartum) units from 326 US hospitals participating in the National Database of Nursing Quality Indicators. Eligible patients were English-speaking adults in pain. Trained nurses collected patients' perceptions via structured interview including 9 pain quality indicators, demographic, and clinical variables; these patient experience data were merged with unit and hospital level data. Analyses included geographic mapping; summary statistics and 3-level mixed effects modeling. Results: Hospitals in 45 states and District of Columbia participated. Of 22,293 screened patients, 15,012 were eligible; 82{\%} verbally consented and participated. Pain prevalence was 72{\%}. Participants were 59.4{\%} female; ages ranged from 19 to 90+ (median: 59 y); 27.3{\%} were nonwhite and 6.5{\%} were Hispanic. Pain intensity on average over the past 24 hours was 6.03 (SD = 2.45) on a 0-10 scale. 28.5{\%} of patients were in severe pain frequently or constantly. Race (nonwhite), younger age, being female and nonsurgical were associated (P < 0.001) with greater pain. Care quality indicators ranking lowest related to discussion of analgesic side effects and use of nonpharmacologic approaches. Conclusions: Unrelieved pain remains a high-volume problem. Individual factors and unit type were significantly associated with pain outcomes. Hospitals can employ these quality indicators to direct continuous quality improvement targeting pain care quality.",
    keywords = "dissemination and implementation, hospitals, nursing, pain, patient experience, quality indicators",
    author = "Beck, {Susan L.} and Nancy Dunton and Patricia Berry and Brant, {Jeannine M.} and Guo, {Jia Wen} and Catima Potter and Beth Spornitz and Jacqueline Eaton and Bob Wong",
    year = "2018",
    month = "1",
    day = "1",
    doi = "10.1097/MLR.0000000000001042",
    language = "English (US)",
    journal = "Medical Care",
    issn = "0025-7079",
    publisher = "Lippincott Williams and Wilkins",

    }

    TY - JOUR

    T1 - Dissemination and Implementation of Patient-centered Indicators of Pain Care Quality and Outcomes

    AU - Beck, Susan L.

    AU - Dunton, Nancy

    AU - Berry, Patricia

    AU - Brant, Jeannine M.

    AU - Guo, Jia Wen

    AU - Potter, Catima

    AU - Spornitz, Beth

    AU - Eaton, Jacqueline

    AU - Wong, Bob

    PY - 2018/1/1

    Y1 - 2018/1/1

    N2 - Background: Previous approaches to measuring and improving nursing-sensitive, patient-centered metrics of pain quality and outcomes in hospitalized patients have been limited. Methods: In this translational research study, we disseminated and implemented pain quality indicators in 1611 medical and/or surgical, step-down, rehabilitation, critical access, and obstetrical (postpartum) units from 326 US hospitals participating in the National Database of Nursing Quality Indicators. Eligible patients were English-speaking adults in pain. Trained nurses collected patients' perceptions via structured interview including 9 pain quality indicators, demographic, and clinical variables; these patient experience data were merged with unit and hospital level data. Analyses included geographic mapping; summary statistics and 3-level mixed effects modeling. Results: Hospitals in 45 states and District of Columbia participated. Of 22,293 screened patients, 15,012 were eligible; 82% verbally consented and participated. Pain prevalence was 72%. Participants were 59.4% female; ages ranged from 19 to 90+ (median: 59 y); 27.3% were nonwhite and 6.5% were Hispanic. Pain intensity on average over the past 24 hours was 6.03 (SD = 2.45) on a 0-10 scale. 28.5% of patients were in severe pain frequently or constantly. Race (nonwhite), younger age, being female and nonsurgical were associated (P < 0.001) with greater pain. Care quality indicators ranking lowest related to discussion of analgesic side effects and use of nonpharmacologic approaches. Conclusions: Unrelieved pain remains a high-volume problem. Individual factors and unit type were significantly associated with pain outcomes. Hospitals can employ these quality indicators to direct continuous quality improvement targeting pain care quality.

    AB - Background: Previous approaches to measuring and improving nursing-sensitive, patient-centered metrics of pain quality and outcomes in hospitalized patients have been limited. Methods: In this translational research study, we disseminated and implemented pain quality indicators in 1611 medical and/or surgical, step-down, rehabilitation, critical access, and obstetrical (postpartum) units from 326 US hospitals participating in the National Database of Nursing Quality Indicators. Eligible patients were English-speaking adults in pain. Trained nurses collected patients' perceptions via structured interview including 9 pain quality indicators, demographic, and clinical variables; these patient experience data were merged with unit and hospital level data. Analyses included geographic mapping; summary statistics and 3-level mixed effects modeling. Results: Hospitals in 45 states and District of Columbia participated. Of 22,293 screened patients, 15,012 were eligible; 82% verbally consented and participated. Pain prevalence was 72%. Participants were 59.4% female; ages ranged from 19 to 90+ (median: 59 y); 27.3% were nonwhite and 6.5% were Hispanic. Pain intensity on average over the past 24 hours was 6.03 (SD = 2.45) on a 0-10 scale. 28.5% of patients were in severe pain frequently or constantly. Race (nonwhite), younger age, being female and nonsurgical were associated (P < 0.001) with greater pain. Care quality indicators ranking lowest related to discussion of analgesic side effects and use of nonpharmacologic approaches. Conclusions: Unrelieved pain remains a high-volume problem. Individual factors and unit type were significantly associated with pain outcomes. Hospitals can employ these quality indicators to direct continuous quality improvement targeting pain care quality.

    KW - dissemination and implementation

    KW - hospitals

    KW - nursing

    KW - pain

    KW - patient experience

    KW - quality indicators

    UR - http://www.scopus.com/inward/record.url?scp=85059155399&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=85059155399&partnerID=8YFLogxK

    U2 - 10.1097/MLR.0000000000001042

    DO - 10.1097/MLR.0000000000001042

    M3 - Article

    C2 - 30570589

    AN - SCOPUS:85059155399

    JO - Medical Care

    JF - Medical Care

    SN - 0025-7079

    ER -