Reducing time to analgesia in the emergency department using a nurse-initiated pain protocol: a before-and-after study.

Review article: Systematic review of three key strategies designed to improve patient flow through the emergency department

“…The CIN role in the ED was developed to support triage nurses. 48 It is a role that utilises advanced nursing practice that can include nurse-initiated (NI) activities, such as analgesia 33,36,49,50 and X-rays. [27][28][29][30]37 The CIN role has been shown to impact on outcomes, such as DNW rate.…”

“…30 Different sample selection, nursing staff designation and levels of training and departmental busyness might impact on these outcomes and thus the broader applicability of the findings. In terms of NI analgesia, multiple studies suggest time to analgesia was improved with the introduction of NI analgesia protocols; 36,49,50 however, there was limited research evaluating the impact of NI analgesia on patient flow. However, one study included in the review did indicate that ED LOS was not impacted by this practice.…”

Relationship Between Empathy and Well-Being Among Emergency Nurses

“…1 A more recent study noted gaps in pain management. 2 Clearly, at a time when multiple analgesics are available and postanalgesia monitoring can be performed via heartmonitoring devices, this lack of pain relief calls for exploration. The Fosnocht team 3 has provided one explanation: the main goal of ED care is to identify the cause of pain, overshadowing the management of that pain.…”

Patient-controlled oral analgesia for acute abdominal pain: A before-and-after intervention study on pain intensity and use of analgesics

“…To provide early administration of analgesics in the ED, studies of nurse-initiated pain management have been conducted. One study reported that use of a nurse-initiated non-opioid analgesic protocol reduced time to administration of analgesics from 98 to 28 minutes after hospital arrival, but did not achieve adequate analgesic effect (Finn et al, 2012), defined as a reduction in pain score of ≥2 to a level <4 (Jao, Taylor, Taylor, Khan, & Chae, 2011). Another study reported that use of a nurse-initiated intravenous opioid analgesic protocol reduced time to analgesics from 108 to 60 minutes and a reduction of pain scores of "weak pain" from 4.1 to 3.7 (Muntlin et al, 2011).…”