A Quality Initiative Incorporating Tablet Technology to Facilitate Nonpharmacologic Pain Intervention Use in the Hospital

Abstract

PurposeThis Quality Improvement (QI) project aimed to increase awareness and use of hospital-endorsed nonpharmacological interventions (NPIs) by engaging both nursing staff and patients on one medical unit using tablet technology. The project utilized existing MyChart Bedside iPads to help promote patient comfort during the hospitalization. MethodsPre-/post-intervention data were collected using surveys of nurse and nursing assistant perceptions of NPIs. Assessment of patient pain management experiences in acute care settings were conducted using the American Pain Society-Pain Outcomes Questionnaire-Revised (APS-POQ-R). Interventions included staff education, integration of an NPI menu and tools onto bedside tablets, and creation of a Comfort Card communication tool. Designated volunteers helped demonstrate to patients how to navigate to the NPI resources on the tablets. ResultsNursing staff (RNs and CNAs) believe NPIs are beneficial, safe, and evidence-based, however, limited resources, time constraints, and lack of provider support were perceived as barriers to providing them. During the 8-week project, staff and volunteers provided 80 comfort items to 38 patients. During post-intervention APS-POQ-R interviews, half of baseline patients (n=30) and intervention (n=15) groups reported not receiving information about pain treatment options. Patients in both groups initially denied using “non-medicine methods,” yet further assessment revealed that 90% of the baseline group and 87% of the intervention group had used one or more NPIs while hospitalized, suggesting a lack of familiarity with these interventions for the purpose of pain management. The role of nursing assistants in the provision of NPIs is also discussed. ConclusionResults suggest that both patients and nurses may benefit from education about using NPIs in acute care. Nurses have a critical role influencing positive pain-related outcomes, and tablet technology can enhance patient use of NPIs during hospitalization.