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Advanced Emergency Nursing Journal:
doi: 10.1097/TME.0b013e3181da588c
Research to Practice

Evidence‐Based Sickle Cell Pain Management in the Emergency Department

Odesina, Victoria DNP, APRN, PHCNS-BC, CCRP, APNG; Bellini, Sandra DNP; Leger, Robin PhD, RN; Bona, Robert MD; Delaney, Colleen PhD, RN, AHN-BC; Andemariam, Biree MD; Bacarro, Nancy APRN, AOCN, ANP, PCM-BC, MS; Lundquist, Kathleen MSN; Donahoe, Sandra P. BSIE, MBA, CPHQ; D'Angelo, Susan RN; Gorenbeyn, Aleksandr MD; Goodrich, SueEllen MSN; Tafas, Cheryl D. RN, MS

Section Editor(s): Howard, Patricia Kunz PhD, RN, CEN, CPEN, FAEN; Broering, Beth MSN, RN, CEN, CPEN, CCRN, FAEN

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Abstract

This quality improvement project addressed the gaps in sickle cell pain management at a suburban teaching hospital emergency department. The aims were to (1) measure baseline pain management practices for patients with sickle cell disease in the ED and (2) implement an adapted emergency department sickle cell pain management clinical pathway. A retrospective chart review was conducted for data abstraction on pain management practices. Medical record review from 44 patient visits showed a high use of monotherapy, delay in time to medical evaluation, medication order, and time to first and subsequent analgesic administration and pain reassessments. Results were used by a multidisciplinary team to develop and implement an evidence-based clinical pathway to improve sickle cell disease pain management. The clinical pathway development was guided by both the advancing research through close collaboration model (ARCC) and Levine's principles of conservation to provide holistic care while preserving vital organs.

© 2010 Lippincott Williams & Wilkins, Inc.

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