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Enhancing Cancer Pain Assessment and Management in Hospice

Miner, Melissa B., DNP, RN, CNE; Stephens, Kimberly, DNP, RN; Swanson-Biearman, Brenda, DNP, MPH, RN; Leone, Vickie, DNP, RN; Whiteman, Kimberly, DNP, RN

Journal of Hospice & Palliative Nursing: October 2018 - Volume 20 - Issue 5 - p 452–458
doi: 10.1097/NJH.0000000000000467
Feature Articles

Pain is one of the most common symptoms in individuals with cancer and is directly associated with significantly reduced quality of life. The purpose of this project was to enhance assessment and management of cancer-related pain for patients in the hospice setting. Nurse attitudes and knowledge about pain were evaluated using the Nurses' Knowledge and Attitudes Survey Regarding Pain before and 6 weeks after an educational program. Nurses completed a pain assessment at each home visit and followed an algorithm based on the National Comprehensive Cancer Network Clinical Practice Guidelines to manage pain. Baseline data were collected on the last 30 patients admitted into hospice with cancer as the primary diagnosis before project implementation. Following the practice change, chart audits of the patients' reported pain and adherence to recommended management were manually extracted from 26 patient records. Results revealed statistically significant differences in acquired knowledge (t = 3.95, P < .05) and attainment of patient-identified pain goals (t = 23.904, P < .05). Patient-reported pain levels decreased by 21%, and comprehensive pain assessment completion rates increased by 10% during the project. Current knowledge of evidence-based pain interventions and a management algorithm improved pain control in patients with cancer.

Melissa B. Miner, DNP, RN, CNE, is a graduate, Waynesburg University, Pennsylvania.

Kimberly Stephens, DNP, RN, is assistant professor, Waynesburg University, Pennsylvania.

Brenda Swanson-Biearman, DNP, MPH, RN, is assistant professor, Duquesne University, Pittsburgh, Pennsylvania.

Vickie Leone, DNP, RN, is vice president, Fayette Home Care & Hospice, Lemont Furnace, Pennsylvania.

Kimberly Whiteman, DNP, RN, is assistant professor, Waynesburg University, Pennsylvania.

Address correspondence to Melissa B. Miner, MSN, RN, CNE, The Pennsylvania State University, 2201 University Dr, Lemont Furnace, PA 15456 (mbm12@psu.edu).

The authors have no conflicts of interest to disclose.

© 2018 by The Hospice and Palliative Nurses Association.