Strategies to improve pain management practice

Background
In 2000/2001 the Children's Pain Management Service (CPMS) at RCH, Melbourne undertook a review of paediatric pain management at the hospital. Findings showed deficits in the areas of staff knowledge and training about pain and a low level of awareness of the importance of pain management.

Method
The CPMS Clinical Nurse Consultants implemented hospital-wide strategies to enhance knowledge about children's pain and to improve pain management practices. Strategies directed at staff included redesigning charts with a stronger pain focus, implementing education posters and 'ID' size pain assessment tools and holding a pain awareness week. Other strategies were directed at children and families with the aim of empowering them to request better pain management.

Results
The different strategies have had varying degrees of success. Positive changes noted to date have been improved attitudes to pain, increased requests for pain education, improved documentation about pain, increased patient referrals to CPMS and an enhanced awareness of optimal pain management practices.

Conclusions
Improving management of pain requires significant work to overcome the discordance between knowledge and practice, an ongoing commitment to education and a core group of people with a strong belief in the importance of pain management.