Veteran and Provider Simulations Improve Pain Scores During Acute Rebab (1090-002266) (Research Abstract Professor Rounds: Group 4)
Start time: Thursday, January 28, 2021, 1:00 PM End time: Thursday, January 28, 2021, 2:00 PM Session Type: Research Abstracts (Completed Studies)
In the United States, pain is a widely discussed issue, largely in part, due to the opioid epidemic that stems from a history of mismanagement of pain. Evidence of successful pain management techniques and tools are present in the literature and should be incorporated into the patient care plan. This study synthesized and utilized evidence-based research and applied it to an acute care rehab unit in a Veterans Affairs medical facility. The project aim was to decrease the number of patients reporting moderate to severe pain through low fidelity simulation exercises with Veterans and frontline care providers and enhance staff communication with a goal of improving pain management and the process by which a Veteran's pain is assessed, treated, and reassessed.
After a simulated tabletop discussion with the interprofessional team members. A pain management protocol template was created for provider use which included an assessment, treatment, and reassessment of the Veterans pain. The template was initiated within 48 hours of admission. If a treatment plan was initiated, the provider reassessed for effectiveness of treatment within five to seven days. This timeline would allow the provider and Veteran to collaborate more closely in managing their pain levels. Pain was included into the daily/weekly interdisciplinary team meetings and huddles. Simulated Case studies were developed along with printed educational materials about pain management for staff. The project manager provided simulated education to the Veterans as well along with education materials to enhance their understanding pain was provided to the patients to enhance their understanding of the pain treatment plan.
As a result of the simulated tabletops and beside case study simulations, there was an identified improvement in recording of the pain severity, interprofessional discussion of pain, increased staff knowledge of pain, pain management and documentation. The Veterans also reported increase satisfaction in their pain knowledge and treatment plan. Outcomes were measured using pre/posttests, a patient roster, data fom the Minimum Data Set 3.0 (MDS 3.0), Computerized Patient Record System (CPRS) to view provider documentation and the Barcode Medication Administration (BCMA) to retrieve data on medication effectiveness. Total data analysis is pending and will be available at time of presentation.
In conclusion, the literature guided this project in choosing a widely researched, valid and reliable pain management framework set forth by the VA guidelines. Incorporating evidence-based guidelines, informatics, simulation educational training, and pain management protocols served as the foundation for the teams’ positive outcomes. The simulation-based interventions aided in producing sustainable and successful outcomes focused on improving Veteran pain education with diverse simulated case scenarios and role playing along with provider and staff assessment, treatment, and reassessment, as well. The next phase will be to disseminate data and share methods with other VA’s to validate the outcomes in other Acute Rehab Settings in hopes of improving pain outcomes for our unique and vulnerable Veteran population.