In1970, Graffam recognized that nurses had difficulty recognizing, responding, and treating patients in pain. Uncontrolled pain in an acute care facility can lead to many problems such as post-operative complications, activation of the sympathetic nervous system, increased pulse, increased respirations, increased blood pressure, increased in-hospital days, and, left untreated, chronic pain. Despite recommendations by the Joint Commission Organization and the Institute of Medicine for improved pain relief measures, patients continue to complain of unrelieved pain. Foreground: Results of the Press Ganey patient satisfaction surveys at a hospital in Henderson, Kentucky, indicated that nurses continue to recieve low patient satisfaction scores in the area of pain management. The Nursing Practice Council and the hospital’s pending Magnet Status require improvement in nursing performance, and patient satisfaction scores, including pain management. Current and future strategic plans for the hospital require that all Press Ganey survey scores be higher than 70%. The current scores are significantly below that target, especially in the area of pain management. Methods: The primary investigator of this project developed and implemented a system change project to address this performance gap at the hospital. The project began with a focus group comprised of bedside nurses that met to discuss the barriers to successful pain management. After the focus group meetings, the primary investigator developed and taught an evidence-based learning module on pain management to the nurses on the medical floor at the hospital. The investigator based the education module on focus group input, literature reviews, and evidence-based practice guidelines. Press Ganey survey results were the means of evaluating the outcome of this specific system change project. Purpose: This project had both short-term and long-term goals. The short-term goals were the results of nurses’ application of knowledge learned in the pain management module. The patients would report improved satisfaction with care and improved inpatient and HCAHPS survey scores in the area of pain management. (b) Long-term goals are the hospital will meet its strategic planning goals related to effective pain management and improved patient satisfaction survey scores. Findings/Results: Following a system change intervention grounded in evidence-based pain management, the Press Ganey Inpatient Surveys and the HCAHPS survey scores showed improvement. Conclusion/Recommendations: Based on the results of this project, the primary investigator recommends that the hospital continue the evidence-based project on pain management to the balance of the hospital nursing staff now and (b) mandate education on pain management to the entire hospital staff on an annual basis. Patient satisfaction in the future will play a role in hospital reimbursement.
