Pain management in Australian emergency departments: Current practice, enablers, barriers and future directions

Bennetts, Scott; Campbell-Brophy, Evylyn; Huckson, Susan; Doherty, Steven

doi:10.1111/j.1742-6723.2011.01499.x

Cited by 30 publications

(35 citation statements)

References 23 publications

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“…The success of any implementing practice change is heavily reliant on senior clinician support (Bennetts et al . ), those that will be impacted by the intervention and those that will be required to act on the intervention (the end users). It is critical to involve end users throughout the research process.…”

Section: Discussionmentioning

confidence: 99%

Translating research findings to clinical nursing practice

Curtis

Fry

Shaban

et al. 2016

Journal of Clinical Nursing

217

173

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Aims and objectivesTo describe the importance of, and methods for, successfully conducting and translating research into clinical practice.BackgroundThere is universal acknowledgement that the clinical care provided to individuals should be informed on the best available evidence. Knowledge and evidence derived from robust scholarly methods should drive our clinical practice, decisions and change to improve the way we deliver care. Translating research evidence to clinical practice is essential to safe, transparent, effective and efficient healthcare provision and meeting the expectations of patients, families and society. Despite its importance, translating research into clinical practice is challenging. There are more nurses in the frontline of health care than any other healthcare profession. As such, nurse‐led research is increasingly recognised as a critical pathway to practical and effective ways of improving patient outcomes. However, there are well‐established barriers to the conduct and translation of research evidence into practice.DesignThis clinical practice discussion paper interprets the knowledge translation literature for clinicians interested in translating research into practice.MethodsThis paper is informed by the scientific literature around knowledge translation, implementation science and clinician behaviour change, and presented from the nurse clinician perspective. We provide practical, evidence‐informed suggestions to overcome the barriers and facilitate enablers of knowledge translation. Examples of nurse‐led research incorporating the principles of knowledge translation in their study design that have resulted in improvements in patient outcomes are presented in conjunction with supporting evidence.ConclusionsTranslation should be considered in research design, including the end users and an evaluation of the research implementation. The success of research implementation in health care is dependent on clinician/consumer behaviour change and it is critical that implementation strategy includes this.Relevance to practiceTranslating best research evidence can make for a more transparent and sustainable healthcare service, to which nurses are central.

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Section: Discussionmentioning

confidence: 99%

Translating research findings to clinical nursing practice

Curtis

Fry

Shaban

et al. 2016

Journal of Clinical Nursing

217

173

View full text Add to dashboard Cite

show abstract

“…The project leads were encouraged to develop a project plan, gain ethics approval (mandatory), undertake clinical audits (mandatory), feedback audit data to staff, identify their local enablers and barriers, review and refine local pain care processes and initiate supportive hospital policy. The overall strategy was to support tailored local strategies that were effective to the identified local barriers . Local interventions that were reported to hold particular influence at a department level included education, clinician leadership and new clinical guidelines and policies …”

Section: Methodsmentioning

confidence: 99%

“…The PMI aimed to implement recommendations of NHMRC approved guidelines and was conducted over two phases . Phase one involved an audit of ED pain management and investigation of the barriers and enablers to best practice pain management . Phase two (2008–2010), reported in this paper, was a national initiative to improve pain management in EDs.…”

Section: Introductionmentioning

confidence: 99%

National project seeking to improve pain management in the emergency department setting: Findings from the NHMRC‐NICS National Pain Management Initiative

Doherty

Knott

Bennetts

et al. 2012

Emerg Medicine Australasia

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“…The planning and implementation of ChIP included the engagement of stakeholders in its development. As the success of any new protocol relies on senior clinician support, particularly around pain management and coordination of patient care (Bennetts, Campbell‐Brophy, Huckson, & Doherty, ), ChIP was developed with each of the clinical specialties involved in the care of patients with rib fractures and was approved by the hospital executive. Given the multidisciplinary nature of ChIP, a working party of key stakeholders developed a consensus plan to streamline its successful implementation.…”

Section: Introductionmentioning

confidence: 99%

Implementation evaluation and refinement of an intervention to improve blunt chest injury management—A mixed‐methods study

Curtis

Van

Lam

et al. 2017

Journal of Clinical Nursing

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Aims and objectives:To investigate uptake of a Chest Injury Protocol (ChIP), examine factors influencing its implementation and identify interventions for promoting its use.Background: Failure to treat blunt chest injuries in a timely manner with sufficient analgesia, physiotherapy and respiratory support, can lead to complications such as pneumonia and respiratory failure and/or death.Design: This is a mixed-methods implementation evaluation study.Methods: Two methods were used: (i) identification and review of the characteristics of all patients eligible for the ChIP protocol, and (ii) survey of hospital staff opinions mapped to the Theoretical Domains Framework (TDF) to identify barriers and facilitators to implementation. The characteristics and treatment received between the groups were compared using the chi-square test or Fischer's exact test for proportions, and the Mann-Whitney U-test for continuous data. Quantitative survey data were analysed using descriptive statistics. Qualitative data were coded in NVivo 10 using a coding guide based on the TDF and Behaviour Change Wheel (BCW). Identification of interventions to change target behaviours was sourced from the Behaviour Change Technique Taxonomy Version 1 in consultation with stakeholders.Results: Only 68.4% of eligible patients received ChIP. Fifteen facilitators and 10 barriers were identified to influence the implementation of ChIP in the clinical setting. These themes were mapped to 10 of the 14 TDF domains and corresponded with all nine intervention functions in the BCW. Seven of these intervention functions were selected to address the target behaviours and a multi-faceted relaunch of the revised protocol developed. Following re-launch, uptake increased to 91%.Conclusions: This study demonstrated how the BCW may be used to revise and improve a clinical protocol in the ED context.Relevance to clinical practice: Newly implemented clinical protocols should incorporate clinician behaviour change assessment, strategy and interventions. Enhancing the self-efficacy of emergency nurses when performing assessments has the potential to improve patient outcomes and should be included in implementation strategy.behaviour change, behaviour change wheel, chest injury, implementation evaluation, nursing, theoretical domains frameworkThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. (Leone et al., 2008). Patients with at least three rib fractures have a significantly increased risk of in-hospital mortality (Holcomb, McMullin, Kozar, Lygas, & Moore, 2003;Testerman, 2006), an effect even more pronounced in older patients (Kent, Woods, & Bostrom, 2008) in whom each additional rib fracture increases the risk of mortality by 19% and of pneumonia by 27% (Bulger, Arneson, Mock, & Jurkovich, 2000). Much of literature around blunt chest injury advises implementation ...

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Pain management in Australian emergency departments: Current practice, enablers, barriers and future directions

Abstract: Effective and sustainable system change requires a strategy that is initiated within the ED, targets opinion leaders, is supported by evidence, and engages all levels of ED staff.

Cited by 30 publications

References 23 publications

Translating research findings to clinical nursing practice

Translating research findings to clinical nursing practice

National project seeking to improve pain management in the emergency department setting: Findings from the NHMRC‐NICS National Pain Management Initiative

Implementation evaluation and refinement of an intervention to improve blunt chest injury management—A mixed‐methods study

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