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A Pilot to Improve the Pain Medication Education Experience in Hospice

Hay, Brittany B., DNP, ARNP, ANP-BC, FNP-BC; Marcelin, Jackie N., DNP, ARNP, CRRN, FNP-C; Buck, Harleah G., PhD, RN, FPCN, FAAN

Journal of Hospice & Palliative Nursing: June 2019 - Volume 21 - Issue 3 - p 207–214
doi: 10.1097/NJH.0000000000000511
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Pain is one of the most feared symptoms experienced by patients at the end of life and one of the most difficult to manage. Families identify patient comfort as a priority in hospice, yet many have concerns regarding pain management and medication side effects. Timely, open, and ongoing communication with hospice teams can assuage concerns to improve care and outcomes relevant to pain medication use in hospice. A pilot project was undertaken to improve the patient and family/caregiver experience in end-of-life care relevant to communication regarding pain medication side effects and management within an inpatient hospice. A 5% improvement in the Consumer Assessment of Healthcare Providers & Services (CAHPS) Hospice quality indicator 18 (Understanding Side Effects) was sought. An evidence-based, interprofessional educational protocol and tool were designed and implemented to guide pertinent conversations. A 6.6% increase in favorable responses to the CAHPS Hospice target indicator occurred over the course of the pilot. Feedback from staff revealed positive responses to the tool with recommended expansion of use across hospice settings. Educational programming holds promise to support communication with hospice patients and families regarding pain medication side effects and management to improve experiential care quality as reflected in CAHPS Hospice surveys.

Brittany B. Hay, DNP, ARNP, ANP-BC, FNP-BC, is assistant professor, University of South Florida College of Nursing, Tampa.

Jackie N. Marcelin, DNP, ARNP, CRRN, FNP-C, is nurse practitioner and nursing administrator in Tampa.

Harleah G. Buck, PhD, RN, FPCN, FAAN, is associate professor, University of South Florida College of Nursing, Tampa.

Address correspondence to Brittany B. Hay, DNP, ARNP, ANP-BC, FNP-BC, University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 22612-4766 (bhay@health.usf.edu).

The authors have no conflicts of interest to disclose.

© 2019 by The Hospice and Palliative Nurses Association.