Interdisciplinary Collaboration in Chronic Pain Management: Low Dose Ketamine Infusion

Abstract

<h3>Background Information</h3> Despite tremendous efforts in pain management, half of the cancer patients suffer and die with pain. Quality of pain management has a direct effect on the patient perception in the value of cancer treatment. Literature shows Low-Dose Ketamine Infusion produces significant improvements in chronic pain. Transitioning this outpatient procedure to a Non-OR procedure has ensured safer and more effective care aligned with the standard of the regulatory and credentialing agencies. We identified a need for staff education, enhanced communication and inter-departmental collaboration to facilitate high-quality patient care. <h3>Objectives of Project</h3> To ensure effective pain management through patient-centered and an interdisciplinary team-approach to meet the standards of the regulatory and credentialing agencies. <h3>Process of Implementation</h3> The Non-OR Recovery and the Chronic Pain Management teams collaboratively developed a new policy and treatment pathway for low dose Ketamine infusion that meets the scope of the nursing practice decision-making framework. An educational series was completed for all P3 Non OR Recovery nurses and confirmed competencies to assist, monitor and evaluate patient pre, intra, and post procedure. An email group was created to ensure effective communication between teams. An audit tool was established to monitor compliance and to report monthly to the institutional quality board. <h3>Statement of Successful Practice</h3> The transition of Low-Dose Ketamine Infusion from the Chronic Pain Clinic to the Non-OR procedural area and recovery was completed successfully in September 2019. Chart audits of all patients from December 2019 to August 2020 shows 100% compliance in following institutional policy and nursing standard of practice. <h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3> This project demonstrated the success of interdisciplinary collaboration in transitioning care from outpatient to the perioperative setting. Appropriate education, guidance, and resources enable PACU nurses to assume new roles and to provide safe patient-centered care in the perioperative setting.