Quality Improvement Intervention for Pain Management in the ER

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The Improving Pain Relief in Elder Patients improves pain management in the ED.
The Improving Pain Relief in Elder Patients improves pain management in the ED.

HealthDay News -- The Improving Pain Relief in Elder Patients (I-PREP) quality improvement (QI) intervention improves pain management in older adults in the emergency department, according to a study published online November 2 in the Journal of the American Geriatrics Society.1

Teresita M. Hogan, MD, from the University of Chicago, and colleagues conducted a controlled pre/postintervention examination among patients aged 65 years and older with moderate-to-severe pain in an academic urban emergency department. A linked standardized education and continuous QI was conducted for multidisciplinary staff in an emergency department.

The researchers observed a 47.5% increase in the percentage of participants who had a final pain score of 4 or less out of 10. There was significant improvement in the median decrease in pain intensity, from 0.0 to 5.0 (P <.001), and a decrease in the median final pain score from 7.0 to 4.0 (P <.001). 

There was a 43.7% increase in the proportion of participants with any pain improvement (P <.001). A significant increase was seen in pain reassessments, from 51.9 to 82.5% (P <.001). There was a significant increase in the percentage of participants receiving analgesics, from 64.1 to 84.8% (P <.001). The odds of receiving analgesics and having a follow-up pain score documented were increased after the intervention (odds ratios, 3.1 and 4.7, respectively).

"The I-PREP intervention substantially improved pain management in older adults in the emergency department with moderate-to-severe musculoskeletal or abdominal pain," the authors write.

 

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Reference

  1. Hogan TM, Howell MD, Cursio JF, Wong A, Dale W. Improving Pain Relief in Elder Patients (I-PREP): An Emergency Department Education and Quality Intervention. J Am Geriatr Soc. 2016. DOI: 10.1111/jgs.14377.
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