A TeamSTEPPS Approach to Improving the Pain Experience of Obstetric Patients

Abstract

Poster Presentation Purpose for the Program To improve the pain experience of obstetric patients during the inpatient care continuum. Proposed Change To improve pain management as measured by our patients by utilizing a TeamSTEPPS‐based approach through strategic use of technology to standardize pain management practices and medication regimens that account for transitions in care and common sources of pain. Implementation, Outcomes, and Evaluation A multidisciplinary team created computerized pain management order sets. These sets were used to standardize pain medications while taking into account the mode of birth (cesarean vs. vaginal), transitions in care (operating room to postanesthesia care unit and labor and delivery to postpartum), and medication pharmacokinetics to ensure proper timing of medication administration and reduce common medication errors. A multidisciplinary pain task force was created. This group designed and implemented a pain survey used to interview patients during hospitalization. Feedback was used to identify future interventions. Real‐time pain scores were made readily available to caregivers by displaying them on commonly used electronic screens. Additionally, pain rounds and focused event reviews were conducted. TeamSTEPPS concepts were applied. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and Press Ganey (PG) data comparing Q2 2013 (the quarter preceding TeamSTEPPS training) versus Q2 2014 (the most recent intervention) were reviewed. The positive trend across all pain measures for both surveys suggests our pain management program is having a positive effect. Gaps identified in our program include failure to discuss patient expectations before admission, lack of available obstetric (OB)‐specific pain management educational materials, lack of understanding of many patients regarding their pain management plans of care, and lack of guidelines for administration of intravenously controlled substances during labor. Specific future interventions were developed to address each of these gaps. Implications for Nursing Practice Nurses can have a significant effect on the pain experience of patients. It is essential for nurses to participate in team‐based problem solving techniques to address the many layers of complex, multidisciplinary issues affecting this pain experience.