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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

Advanced Emergency Nursing Journal: April-June 2010 - Volume 32 - Issue 2 - p 102–111
doi: 10.1097/TME.0b013e3181da588c

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.

Departments of Medicine (Dr Odesina), Orthopaedic (Dr Leger), and Hematology/Oncology (Dr Bona), School of Medicine, NEAG Comprehensive Cancer Center (Dr Andemariam and Ms Bacarro), Emergency Department (Mss Lundquist and Angelo), Hospital Administrative Services (Ms Donahoe), Traumatology and Emergency Medicine (Dr Gorenbeyn), Nursing Services (Ms Goodrich), and Nursing Education (Ms Tafas), University of Connecticut Health Center, Farmington, Connecticut; and School of Nursing (Drs Bellini and Delaney), University of Connecticut, Storrs, Connecticut.

Corresponding Author: Victoria Odesina, DNP, APRN, PHCNS-BC, CCRP, APNG, Department of Medicine, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06030 (

© 2010 Lippincott Williams & Wilkins, Inc.