The implementation of a Pain Monitoring Programme for nurses in daily clinical practice: results of a follow-up study in five hospitals.

AIMS OF THE STUDY To study the effects of the implementation of a Pain Monitoring Programme (PMP) for nurses in daily clinical practice. In addition, nurses' and physicians' pain knowledge and attitudes were studied, as well as change in nurses' pain knowledge after implementation of the programme. RATIONALE The rationale for the study was that many hospitalized patients suffer from pain and treatment of pain is often inadequate. BACKGROUND Reasons for inadequate treatment of pain are the failure of nurses to assess pain on a daily basis and insufficient knowledge about pain and pain management in both nurses and physicians. The PMP tried to overcome these barriers by implementing daily pain assessment and educating nurses about pain and pain management. RESEARCH METHODS This follow-up study was conducted in five hospitals. In total, 277 nurses and 115 physicians participated. The implementation and long-term effects of the programme were measured with a pretest-post-test design without a control group. RESULTS Results showed that nurses carried out daily pain assessment in at least 75% of patients during the first 5 months of the intervention period, but in the remaining 2 months professional compliance gradually decreased. Both nurses and physicians are positive about daily pain assessment and want to continue with it. The level of nurses' and physicians' knowledge about pain and pain management is moderate. The programme increased nurses' knowledge and satisfaction regarding the quality of pain treatment. DISCUSSION Because professional compliance decreased after 5 months, incentives are needed to motivate nurses to continue with daily pain assessment. Continuous Quality Improvement may be a useful method to guide the implementation process. CONCLUSIONS Based on these results it can be concluded that it is possible to implement the PMP in daily clinical practice. Moreover, the beneficial effects of our programme on nurses' knowledge and attitudes have been demonstrated. Therefore, participating hospitals were advised to continue and extend the programme and other hospitals are encouraged to implement it.