The World Health Organization recognizes that millions of people world-side suffer from pain because of “ignorance of doctors and the lack of a standardized scientific approach” to correctly diagosis and properly treat pain. The Institute of Medicine (IOM) views pain as a US public health challenge. Pain puts a demand on the health care system. It is costly not only in terms of health care expenditures, but also disability compensation, loss of productivity at work and school, reduced income and quality of life. The IOM is aware that pain prevention and management receive little emphasis in most prelicensure education programs. The Joint Commission in conjunction with the National Pharmaceutical Council agree that a major intervention required to improve pain management practices is the implementation of educational curicula. The National Consensus Project of Quality Palliative Care is a consortium of Hospice and Pallative Care organizations and associations. They develop clinical practice guidelines that “set high expectations for excellence rather than basic competence”. The nurse or clinician needs to insure that education is provided and learning occurs in order for the patient and the family to be empowered and achieve full participation in their care. Examination of current pain management training at the clinical site for this project revealed many deficits starting with outdated pain management information and no formal education plan at orientation. Standardized, on-going pain management education did not exist. Nurses could not educate and empower their patients if nurses did not possess the skills or confidently provide the knowledge necessary to teach the patient and family. The Academic Center for Evidence-Based Practice (ACE) Star Model provided the evidence-based practice framework. The organization change model is based on the work of Kurt Lewin’s Force Field Analysis. Jean Watson’s Human Caring Theory was the nursing theory model employed. Finally, Patricia Benner’s From Novice to Expert Model sets the stage for curriculum development and continued education. The goal of this project was evaluating the effectiveness of employer-based pain management education for hospice nurses. Nursing outcomes included consistent and timely completion of the pain scale with accompanying narrative documentation. The patient outcomes included (a) pain control achieved within 48 hours and (b) actively managed pain control throughout illness. Monthly Performance Improvement Audits for pain management served as the evaluation tool. All nurses completed pain management training by December 2014. Pain audit results showed an increase in use of pain scale at each visit and an increase in number of patients achieving pain control within 48 hours. The results demonstrate that pain management education can have a positive impact on patient comfort and transition in hospice care.
