Implementation results of the assessment and management of pain guideline within Best Practice Spotlight Organisations (BPSO®)

• Published in: Enfermería clínica (Internet. English ed.) 2020-05, Vol.30 (3), p.212-221
• Main Authors: Saiz Vinuesa, M. Dolores, Albornos-Muñoz, Laura, Fernández Núñez, M. Luz, López-García, Maribel, Moreno-Casbas, Teresa, González Sánchez, José Ángel, Moreno-Casbas, María Teresa, González, María E., Luz Fernandez, M., Angel Gonzalez, Jose, Saiz, Dolores
• Format: Article
• Language: English
• Subjects: Atención de enfermería; Ciencia de la implementación; Dolor; Evidence-based practice; Guía de práctica clínica; Implementation science; Nursing care; Pain; Practice guideline; Práctica clínica basada en la evidencia
• ISSN: 2445-1479; 2445-1479
• DOI: 10.1016/j.enfcle.2020.04.001

to analyse the progress of implementing the process recommendations of the RNAO Assessment and Management of Pain guideline and health outcomes. An observational, longitudinal, retrospective study conducted in 3 tertiary-level hospitals in Spain. All patients discharged over the last 5 days of each month from the units selected in the implementation process were included. We evaluated structural data, mean hospital stay, implementation strategy and degree of implementation of the process recommendations of the RNAO guideline over the first 3 years of implementation, and outcomes. A descriptive analysis was performed by calculating means and absolute and relative frequencies in periods: baseline (T0), annual, over the 3 first years of implementation (T1, T2 and T3 respectively), and inferential. 8128 patients were included in the study. Hypotheses were contrasted between the different periods. The initial pain assessment in the first 24h following admission or post-surgery increased after the baseline period in all the hospitals, especially those that did not meet the guidelines from the outset. It continued to rise progressively up to 3 years following implementation (reaching 94.6% in hospital 2). By contrast, implementation of the care plan did not exceed 37.5% and 38.5% in hospitals 1 and 3 respectively. With regard to the outcome indicators, the prevalence of pain at 24h and intense pain generally decreased in the 3 hospitals from T0 or T1 to T3, however no conclusive statistically significant differences were obtained. Implementation of the process recommendations improved from the outset, as did patient outcomes. A decrease in the prevalence and intensity of pain was achieved, although no conclusive data were obtained; all of which leads to better nursing practice with more recording, continuity of care and improved pain management for patients. Analizar la evolución de la implantación de las recomendaciones de proceso de la guía RNAO Valoración y manejo del dolor y de los resultados en salud. Estudio observacional, longitudinal, retrospectivo, realizado en 3 hospitales de tercer nivel de España. Se incluyó a todos los pacientes dados de alta los últimos 5 días de cada mes de las unidades seleccionadas en el proceso de implantación. Se evaluaron datos estructurales, estancia media, estrategia de implantación y grado de implantación de recomendaciones de proceso según la guía RNAO durante los 3 primeros años de implantación y resultados. Se realizó un