Interventions to improve the management of pain in emergency departments: systematic review and narrative synthesis

Abstract

Introduction

Regional nerve blockade for early analgesic management of elderly patients with hip fracture – a narrative review

“…To facilitate the translation of evidence into practice, these issues need to be addressed with support from administrators, policy makers, clinicians and funders. Education and training is vital to ensure that knowledge, confidence and competency in best‐practice nerve block techniques remain high among emergency staff . Identifying local champions, trainers and auditors could be a useful way to initiate change and shift thinking from a universal reliance on opiates for the management of acute pain in the elderly .…”

Medication knowledge and willingness to nurse‐initiate medications in an emergency department: a mixed‐methods study

“…In the UK the pain management protocols or algorithms commenced in the late 1990s (Goodacre & Roden 1996). Currently, this intervention accompanied by an educational component is commonly practiced in the UK and in other parts of Europe (Sampson et al 2014). In Australia, a similar intervention known as nurse-initiated analgesia (NIA) is being employed successfully in major EDs, where nurses are able to autonomously administer analgesia including opioids as clinically indicated from a formulary (Fry et al 2011, Shaban et al 2012, Doherty et al 2013.…”

Improving Pain Relief in Elder Patients (I‐PREP): An Emergency Department Education and Quality Intervention

“…Isolated education and quality improvement (QI) efforts have been shown to have short‐term success. A systematic search of medical databases failed to find any intervention to improve management of pain in the ED that is effective enough to recommend for widespread adoption …”

“…A systematic search of medical databases failed to find any intervention to improve management of pain in the ED that is effective enough to recommend for widespread adoption. 9 For these reasons, a coordinated QI intervention tightly linking education and QI-the Improving Pain Relief in Elder Patients (I-PREP) program-was developed and deployed. It was hypothesized that linking education with quality tools, metrics, and feedback would significantly improve pain relief.…”