Experiences Of Pain Management Research Articles

Factors that influence the quality of pain management in patients with skin traction

BackgroundPain management is a systematic multidimensional process with differing approaches. Investigating the factors that affect the quality of pain management may provide nurses with ideas, suggestions, and trends that target improvements in the pain management experience among orthopaedic patients. AimsTo assess the elements of the quality of pain management and identify factors that significantly predict higher quality pain management in patients with skin traction. MethodsA descriptive correlational design was used to recruit a convenience sample of 116 patients. The revised American Pain Society Patient Outcome Questionnaire was used to explore the quality of pain management. ResultsPatients suffered from severe pain for more than 64% of the time during the first 24 h after the skin traction was applied. The uncontrolled pain negatively affected patients’ abilities to carry out activities in bed, fall asleep, and stay asleep. The quality of pain management indicators using a scale of one to 10 were: “pain severity" = 5.93, “pain interference" = 5.01, “side effects of medications" = 1.5”, and “satisfaction about care" = 6.2”. ConclusionsThe quality of pain management for fracture patients on skin traction was not optimum in this study. The uncontrolled pain negatively affected patients’ physical status and general wellbeing.

A Comparison of Rural and Urban Hospice Family Caregivers' Cancer Pain Knowledge and Experience

ContextFamily caregivers play a vital role in managing the pain of hospice patients with cancer; however, caregivers' knowledge of pain management principles and experiences as pain managers vary widely. Differences in cultural values and access to resources suggest that rural and urban hospice family caregivers may differ with regard to their pain knowledge and experience, but this has not been empirically investigated. ObjectivesWe sought to determine if rural and urban hospice family caregivers differed in terms of their knowledge of cancer pain management principles and their experiences managing cancer pain. MethodsOur study consisted of a secondary analysis of baseline, cross-sectional data from hospice family caregivers (N = 196) participating in an ongoing cluster randomized crossover pragmatic trial. We performed multivariable regression to model associations between caregivers' demographic characteristics and their scores on the Family Pain Questionnaire (FPQ), which included subscales measuring pain knowledge and experience. ResultsWhen controlling for other demographic variables, rural caregivers' scores on the FPQ knowledge subscale were worse (P = 0.01) than their urban counterparts. FPQ experience subscale scores and FPQ total scores were not statistically significantly different between the two groups. ConclusionRural hospice family caregivers report greater pain knowledge deficits than urban hospice family caregivers, although the two groups report comparable pain management experiences. Additional research is needed to better explain observed differences.

Factors Influencing Patients' Experiences of Pain Management in the Emergency Department.

Despite management of acute pain, concerns regarding pain are still prevalent in the emergency department (ED). This study aimed to explore the factors influencing patients' pain management in a Jordanian ED. Fifteen semistructured interviews (N = 15) with purposively selected patients in the ED. The thematic analysis uncovered two related themes. The first theme described the stage of "being on ED bed" which encapsulates two subthemes: "bad pain means, bad diagnosis" and "smiley faces versus grumpy faces." The second theme referred to as "being discharged" including two subthemes, namely, "praying for not paying" and "being grateful to God." The lack of money to pay for pain management was equally as stressful as pain itself. Patients' narratives suggest that nursing pain management is a critical time, extending beyond medical management to encompass communication and spirituality. The factors influencing the patients' experience of pain management extend beyond addressing the source of the pain. Consequently, effective communication coupled with respecting patients' spirituality and socioeconomic concerns is essential to pain management. To enhance patients' experience of pain management, the ED system should shift toward a patient-centric model.

Postoperative Patients in Jordan: Pain Prevalence, Characteristics, Beliefs, and Satisfaction

BackgroundUnrelieved postoperative pain contributes to soaring medical costs and poor quality of life. Whilst much has been written about postoperative pain prevalence in the literature, few empirical studies have explored pain care in Middle Eastern countries. AimsThis study aimed to determine pain prevalence, its characteristics, beliefs and satisfaction among postoperative patients in Jordan. DesignThis is a descriptive survey design. SettingsThis study was conducted in a 200-bed Jordanian public hospital located in the southern province of Jordan. ParticipantsA convenient sample of 143 surgical patients was selected. MethodsData were collected by the American Pain Society Patient Outcomes questionnaire, Brief Pain Inventory scale and beliefs towards pain scale. Data were analyzed using SPSS version 21. ResultsPain prevalence following surgery during the first 24 hours was 87%. The overall Mean of satisfaction of all participants was moderate (66.6%). The analysis found that the greatest interference of pain was with activity (Mean ± SD = 6.27 ± 3.30). The belief “people get addicted to pain medicine easily” was the most common misunderstanding (Mean ± SD = 3.48 ± 1.71). Male participants had worse average pain experience but were more satisfied with pain management than females (ps = .012, .017, respectively). Participants aged 30 or more had better pain management experience and satisfaction than those aged under 30 (p = .021). ConclusionsThe study revealed high pain prevalence among surgical patients that remains undertreated. If patients’ postoperative environment is to be a “Pain Free Zone”, nurses’ training programs and the application of various screening tools in the postoperative context taking into account the role of gender and culture are urgently needed.

DAMPAK INTERVENSI EDUKASI TERHADAP PENGETAHUAN, SIKAP, DAN KETERAMPILAN ORANG TUA DALAM MENGELOLA NYERI PADA ANAK DENGAN KANKER

Introduction pain in children suffers from cancer gives effect in short term and long term. Most parents do not know how to assess pain in children. They have not used a pain scale based on children age to measure pain. Health education pain management has not been structured for patients so the given information is not optimal. The purpose this study aims to identify the impact of education intervention to the parent’s knowledge, attitudes, and skills in managing pain of children suffers from cancer. This research method This study used a quasi-experimental with one group pretest-posttest. The sample was 29 people in RSAB Harapan Kita and Gatot Subroto Army Hospital, taken by consecutive sampling. The data was analyzed by McNemar and Chi Square. The results showed a significant difference in the aspect of knowledge, attitudes and skills of parent in the pain management of children before and after health education (knowledge, p = 0.001; Attitudes, p = 0.001 and skill, p < 0.001). The conclusion characteristics of parents associated with the knowledge and attitudes who have children suffers from cancer is pain management experience. Suggestions recommendation for this study is the health education about pain management should be carried out intensively.

A PharmD program curricular approach to addressing the opioid crisis

Background and purposeThe opioid crisis in the United States is widespread and requires large scale efforts to reduce the problem. A recent call by the American Association of Colleges of Pharmacy requested commitments by member schools to enact curricular changes in order to prepare pharmacy graduates to be impactful in addressing the opioid crisis. Educational activityA taskforce reviewed existing pain management and opioid-related curricular content in the North Dakota State University School of Pharmacy (NDSU SOP). As a result, all pre-existing opioid-related content was maintained and six new educational activities were designed and implemented to enhance hands-on experience and application of pain management and opioid-related concepts and skills. Students were surveyed after completing the pre-APPE curriculum regarding their confidence in identifying inappropriate use of opioids and engaging in conversations with patients about safe opioid use. FindingsThe full longitudinal approach to addressing pain management and opioid content in the North Dakota State University School of Pharmacy program is described. Curricular gap analysis, thoughtful coordination, faculty collaboration, and curriculum mapping were required in order to bring the full pain management and opioid curricular plan to fruition. The vast majority of students were confident in their ability to counsel patients on appropriate options for safe use and disposal of opioids (96%) and their ability to determine if a patient is at risk for opioid misuse (92%). A lower percentage (71%) were confident in their ability to converse with patients regarding opioid misuse concerns. SummaryThis is the first report to summarize a longitudinal, curriculum-wide approach taken to address the opioid crisis in the United States and in response to AACP's call to action for pharmacy schools. This description may be valuable to other pharmacy and health professions educational programs in search of means to implement and/or enhance their current curricular offerings related to pain management and opioids.

Patient-controlled oral analgesia at acute abdominal pain: A before-and-after intervention study of pain management during hospital stay

AimTo investigate the patient experience of pain management, when patient-controlled oral analgesia was compared with standard care for patients admitted to hospital with acute abdominal pain. The primary outcome measures were pain intensity and patient perception of care. BackgroundPain management of patients admitted to hospital with acute abdominal pain can be insufficient. Patient involvement in health care has been seen to have benefits for patients. MethodsA before-and-after intervention study was conducted in an emergency department observation unit and a surgical department. Data were collected from a questionnaire (APS-POQ-R-D) with the six subscales: pain severity, perception of care, interference with activity, interference with emotions, side effects and patient-related barriers. ResultsA total of 156 patients were included. During admission the median score (0–10 scale) for the pain intensity and patient perception of care subscale was 4 (p = 0.96) and 8 (p = 0.92), respectively, in both the control and intervention group. On the activity subscale, the median scores were 6 and 5 (p = 0.17); on the emotion subscale, the scores were 5 and 4 (p = 0.31); and on the side effect subscale, the scores were 3 and 4 (p = 0.18) in the control and intervention group, respectively. Overall, the score was 5–8 at one item about being allowed to participate in decisions about pain treatment as much as wanted. ConclusionPatient-controlled oral analgesia did not improve patient experience of pain management for patients admitted to hospital with acute abdominal pain.

The Opioid Epidemic and Opioid Prescribing Regulations: A Survey Exploring Potential Barriers to Adequate Pain Management in Adults with Cancer (FR440B)

•Identify current opioid prescribing regulations and describe their perceived impact on adult cancer patients in an outpatient palliative care clinic.•Identify factors that impact adult cancer patients’ experience of pain and pain management in the current climate of the “opioid crisis.”•Identify future areas of needed research to lessen the adverse impact of the “opioid crisis” and prescribing regulations on palliative care patients. In the United States, there has been an increase in opioid misuse leading to increased monitoring. Although many guidelines exclude treatment of palliative patients, it remains important to evaluate all patients receiving opioids for substance misuse to ensure safety. The primary objective was to determine if current opioid prescribing regulations are perceived by adult cancer patients as a barrier to adequate pain management. Following a review of the literature and discussion with palliative experts, we identified potential concerns for patients with prescribing guidelines and developed a 21-item survey. We used a convenience sample of patients receiving opioids in the University of Virginia Palliative Care clinic during the period from February to April 2018. We used chi-square and t-tests to evaluate the correlation between patient perceptions that regulations made pain management difficult and demographic variables, pain and physical function scores, and the opioid risk tool (ORT). Ninety patients completed the survey. The majority (88.9%) were aware of opioid prescribing laws and 83.2% agreed that opioid abuse is a problem. One-third reported increased regulations made it difficult to manage pain (37.1%) or that insurance issues were a barrier to getting pain medications (32.6%). 38.9% of patients reported their doctor is less likely to prescribe strong pain medications due to the opioid crisis and 24% stated family or friends have told them not to take opiates. In univariate analyses, patients with higher ORT scores (p=0.025) and those with higher pain scores (p=0.0058) were more likely to report difficulty obtaining pain medications due to prescribing regulations. This initial survey suggests many palliative care patients feel the increase in opioid prescribing regulations is a barrier to adequate pain management.

Impact of a pharmacist-directed pain management service on inpatient opioid use, pain control, and patient safety.

To evaluate the impact of a pharmacy-directed pain management service (PPMS) designed to optimize analgesic pharmacotherapy, minimize adverse events, and improve patients' experience of pain management. A retrospective analysis was conducted to evaluate the PPMS consisting of 3 dedicated pain management clinical pharmacists who perform both consult-based and stewardship functions. Multiple measures of opioid use and associated patient satisfaction outcomes during 3-year periods before and after implementation of the PPMS were compared. Significant decreases in use of institutionally defined high-risk opioid medications (e.g., parenteral hydromorphone, fentanyl, transdermal fentanyl patches), a decrease in total institutional opioid use, increased coanalgesic and adjunctive medication use, and a decrease in rapid response team (RRT) and code blue events associated with opioid-induced oversedation were seen after service implementation. Despite decreased opioid use, available patient satisfaction data suggested ongoing improvement in associated Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey domains. Our data highlights the impact of a pharmacy directed pain management service on institutional opioid use with available data suggesting improved patient satisfaction scores and indirect cost savings. Despite decreased opioid use, available patient satisfaction data suggested ongoing improvement in associated HCAHPS survey pain management domains.

Nurses’ Experience of Pain Management in Patients Referred to the Emergency Department

Nurses’ Experience of Pain Management in Patients Referred to the Emergency Department

Testing a pain self-management intervention by exploring reduction of analgesics\u2019 side effects in cancer outpatients and the involvement of family caregivers: a study protocol (PEINCA-FAM)

BackgroundPain is one of cancer patients’ most frequent and distressing symptoms; however, analgesics’ side effects often increase symptom burden. Further, with the home rapidly becoming the primary cancer care setting, family caregivers (FCs) commonly play central roles in patients’ pain self-management, but with little or no preparation. One US-tested intervention, the PRO-SELF© Plus Pain Control Program (PCP), designed to support cancer outpatients and their FCs in pain self-management, is currently being tested in the Swiss multi-centre PEINCA study. The current PEINCA-FAM study is a sub-study of PEINCA. The aims of PEINCA-FAM are: a) to test the efficacy of the adapted German PRO-SELF © Plus PCP to reduce side effects of analgesics; b) to enhance patients’/FCs’ knowledge regarding cancer pain; and c) to explore FCs’ involvement in patients’ pain self-management.MethodsThis mixed methods project combines a multi-centre randomized controlled clinical trial with qualitative data collection techniques and includes 210 patients recruited from three oncology outpatient clinics. FCs involved in patients’ pain self-management are also invited to participate. After baseline evaluation, eligible participants are randomized to a 6-week intervention group and a control group. Both groups complete a daily pain and symptom diary. Intervention group patients/FCs receive the weekly psychoeducational PRO-SELF© Plus PCP interventions; control group patients receive usual care. After completing the six-week study procedures, a subsample of 7–10 patients/FCs per group and hospital (N = 42–60) will be interviewed regarding their pain management experiences. Data collection will take place from April 2016 until December 2018. An intent-to-treat analysis and generalized linear mixed models will be applied. Qualitative data will be analysed by using interpretive description. Quantitative and qualitative results will be combined within a mixed method matrix.DiscussionIn clinical practice, specially trained oncology nurses in outpatient clinics could apply the intervention to reduce side effects and to enhance patients’/FCs’ self-efficacy and pain management knowledge.Trial registrationThe PEINCA study is registered in the Clinical Trials.gov site (code: NCT02713919, 08 March 2016).

Evaluation of the quality of acute pain management in a pediatric surgical setting: Validation of a parent proxy modified version of the revised American Pain Society Patient Outcome Questionnaire.

Effective pain management involves a cycle of continual pain assessment, good pain control strategies, and assessment of a standard quality improvement measures. A validated questionnaire that focuses on the quality of postoperative pain management in pediatric surgical patients and parental satisfaction on pain treatment is lacking. We, therefore, modified the revised American Pain Society Patient Outcome Questionnaire to evaluate the quality of postoperative pain management in a pediatric surgical setting. The primary aim of this study was to validate the modified version of revised American Pain Society Patient Outcome Questionnaire. Parents whose children aged below 12years and were scheduled for elective surgery in a teaching hospital, were approached to participate in this survey. The reliability of the modified version of revised American Pain Society Patient Outcome Questionnaire was evaluated using Cronbach's alpha test, while the construct validity was assessed with a principal component analysis using a varimax rotation. The parental satisfaction with pain treatment received was measured. A total of 108 parents completed the questionnaire. The internal consistency of the questionnaire shows a Cronbach's alpha of 0.798. Principal component analysis revealed a four-factor structure of the 12 items which explained 69.7% of the total variance. The factors are "Interference of sleep and activity," "Pain severity and drowsiness," "Perception of care," and "Adverse effects," respectively. Our study showed that this questionnaire is a valid and reliable measure for "Interference of sleep and activity" and "Pain severity and drowsiness" factors, but not for "Perception of care" and "Adverse effects." The results for "Perception of care" and "Adverse effects," therefore, should be reported as individual items instead of total score. The parental satisfaction with pain treatment given was good (median 8.0; IQR 3.0). The modified version of revised American Pain Society Patient Outcome Questionnaire is a feasible and easy instrument to administer. The questionnaire can be used to obtain feedback from parents about the outcomes and experiences of pain management and is helpful in continuous quality evaluation and improvement in the postoperative care in a pediatric setting.

Patients' Experiences of Pain Have an Impact on Their Pain Management Attitudes and Strategies

Objectives: Postoperative pain remains undermanaged in orthopedic surgery. To identify areas of improvement for future structural changes in pain management, patients’ experiences of pain and pain management when undergoing elective lumbar spine surgery were explored, using a qualitative method with focus group interviews. Setting: The study setting was an orthopedic spine surgery department at a University Hospital in Sweden. Methods: This study consisted of two focus group interviews with patients (n = 6/group, a total of 12 patients) who had undergone lumbar spine surgery 4 days to 5 weeks prior to the focus group interviews. The interviews were semi-structured, and the analysis was performed using qualitative content analysis. Results: The main result of this study revealed that patients’ experiences of pain influenced their attitudes and strategies for pain management. Three main categories emerged from the focus group interviews: I. Coping with pain while waiting for surgery; II. Using different pain-relieving strategies after surgery; and III. How organizational structures influence the pain experiences. Conclusions: In conclusion the results from this study acknowledge that postoperative pain experiences and coping strategies after spine surgery are highly diverse and individual. This calls for staff having a more personalized approach to pain management in order to optimize pain relief, which was stressed as highly valued by the patients.

Person-centred pain management for the patient with acute abdominal pain: An ethnography informed by the Fundamentals of Care framework.

To explore and describe the impact of the organizational culture on and the patient-practitioner patterns of actions that contributes to or detract from successful pain management for the patient with acute abdominal pain (AAP) across the acute care pathway. Although pain management is a recognized human right, unmanaged pain continues to cause suffering and prolong hospital care. Unanswered questions about how to successfully manage pain relate to both organizational culture and individual practitioners' performance. Focused ethnography, applying the Developmental Research Sequence and the Fundamentals of Care framework. Participant observation and informal interviews (92hr) were performed at one emergency department (ED) and two surgical wards at a University Hospital during April-November 2015. Data include 261 interactions between patients, aged ≥18years seeking care for AAP at the ED and admitted to a surgical ward (N=31; aged 20-90years; 14 men, 17 women; 9 with communicative disabilities) and healthcare practitioners (N=198). The observations revealed an organizational culture with considerable impact on how well pain was managed. Well-managed pain presupposed the patient and practitioners to connect in a holistic pain management including a trustful relationship, communication to share knowledge and individualized analgesics. Person-centred pain management requires an organization where patients and practitioners share their knowledge of pain and pain management as true partners. Leaders and practitioners should make small behavioural changes to enable the crucial positive experience of pain management.

Exploration of nurses' pediatric pain management experiences in rural hospitals: A qualitative descriptive study

BackgroundHospitalized children continue to experience inadequate pain management. Children in the rural hospital setting may be at risk due to unique challenges experienced by Registered Nurses (RNs) in this context. ObjectivesTo understand the experience of pain care from RNs who work in rural hospitals with inpatient pediatric patients. DesignQualitative description that used semi-structured interviews to explore RNs' inpatient pediatric pain care experiences. ParticipantsRNs who: 1) worked directly with pediatric in-patients; 2) spoke English; 3) and who worked in rural Northern Ontario. Hospital sites were selected based on population density, from one province in Canada. To reduce heterogeneity, only sites with dedicated pediatric beds were eligible (n = 9). MethodsThis qualitative descriptive study used semi-structured interviews over Skype and telephone. Data were analyzed using inductive content analysis. ResultsTen participants were recruited from seven sites. Five main categories were identified, with one category that influenced all other categories. Rural RNs needed to practice as generalists as they care for many types of patients. Resource challenges included a lack of specialist expertise and educational opportunities. Pediatric pain was not perceived as a priority within their organizations. Most participants perceived there were no explicit standards for pain care. Moving forward the adoption of built in assessments in electronic documentation was suggested as a solution to standard pain care. ConclusionsOpportunity exists to improve pediatric pain management, however, without a systematic approach that considers the rural context, pain care for children will continue to be based on individual's beliefs and knowledge.

A novel inpatient complex pain team: protocol for a mixed-methods evaluation of a single-centre pilot study

IntroductionComplex pain is a debilitating condition that is responsible for low quality of life and significant economic impacts. Although best practice in the treatment of complex pain employs a multidisciplinary...

Patient narratives in Yelp reviews offer insight into opioid experiences and the challenges of pain management.

To characterize Yelp reviews about pain management and opioids. We manually coded and applied natural language processing to 836 Yelp reviews of US hospitals mentioning an opioid medication. Yelp reviews by patients and caregivers describing experiences with pain management and opioids had lower ratings compared with other reviews. Negative descriptions of pain management and opioid-related experiences were more commonly described than positive experiences, and the number of themes they reflected was more diverse. Yelp reviews offer insights into pain management and opioid use that are not assessed by traditional surveys. As a free, highly utilized source of unstructured narratives, Yelp may allow ongoing assessment of policies related to pain management and opioid use.

Using the trauma patient experience and evaluation of hospital discharge practices to inform practice change: A mixed methods study.

To explore the pain management experiences of recently discharged adult trauma patients and the discharge practices of the treating hospital. Adult trauma patients are not always able to manage their pain effectively and as a result often experience intense and enduring injury pain at home. They describe their pain experience as unique and debilitating, and report feeling uninformed at hospital discharge. There is a need to understand what is fundamentally required for this population at hospital discharge, to facilitate competent pain management and promote best possible outcomes. A mixed methods convergent study design. The quantitative results (incidence, intensity and impact of injury pain and the barriers to effective pain management) were merged with the qualitative results (patient experiences and beliefs) to produce greater understanding about the reasons behind the pain management practices of participants. Integration of the quantitative and qualitative data produced four new themes. These themes demonstrate that recently discharged adult trauma patients do not have the knowledge or experience to understand or manage their injury pain effectively at home. Inadequate information and education by clinicians, at hospital discharge, contribute to this insufficiency. Clinicians need to understand the trauma patient pain experience to appreciate the importance of their discharge practices. Increased understanding and implementation of evidence-informed discharge processes would improve current discharge practices and ultimately support and improve the trauma patient's injury pain management practices at home. By understanding the patient perspective in the pain management of injuries, clinicians are better able to appreciate what hospital discharge practices and information are genuinely required by the trauma patient to manage their pain effectively at home, potentially preventing the long-term consequences of injury pain.

Cancer pain management needs and perspectives of patients from Chinese backgrounds: a systematic review of the Chinese and English literature.

More than half of all cancer patients experience unrelieved pain. Culture can significantly affect patients' cancer pain-related beliefs and behaviors. Little is known about cultural impact on Chinese cancer patients' pain management. The objective of this review was to describe pain management experiences of cancer patients from Chinese backgrounds and to identify barriers affecting their pain management. A systematic review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they reported pain management experiences of adult cancer patients from Chinese backgrounds. Five databases were searched for peer-reviewed articles published in English or Chinese journals between1990 and 2015. The quality of included studies was assessed using Joanna Briggs Institution's appraisal tools. Of 3,904 identified records, 23 articles met criteria and provided primary data from 6,110 patients. Suboptimal analgesic use, delays in receiving treatment, reluctance to report pain, and/or poor adherence to prescribed analgesics contributed to the patients' inadequate pain control. Patient-related barriers included fatalism, desire to be good, low pain control belief, pain endurance beliefs, and negative effect beliefs. Patients and family shared barriers about fear of addiction and concerns on analgesic side effects and disease progression. Health professional-related barriers were poor communication, ineffective management of pain, and analgesic side effects. Healthcare system-related barriers included limited access to analgesics and/or after hour pain services and lack of health insurance.Significance of resultsChinese cancer patients' misconceptions regarding pain and analgesics may present as the main barriers to optimal pain relief. Findings of this review may inform health interventions to improve cancer pain management outcomes for patients from Chinese backgrounds. Future studies on patients' nonpharmacology intervention-related experiences are required to inform multidisciplinary and biopsychosocial approaches for culturally appropriate pain management.

Leveraging Interactive Patient Care Technology to Improve Pain Management Engagement

Background: Most children experience pain in hospitals; and their parents report dissatisfaction with how well pain was managed. Engaging patients and families in the development and evaluation of pain treatment plans may improve perceptions of pain management and hospital experiences. Objectives: The aim of this performance improvement project was to engage patients and families to address hospitalized pediatric patients' pain using interactive patient care technology. The goal was to stimulate conversations about pain management expectations and perceptions of treatment plan effectiveness among patients, parents, and health care teams. Methods: Plan-Do-Study-Act was used to design, develop, test, and pilot new workflows to integrate the interactive patient care technology system with the automated medication dispensing system and document actions from both systems into the electronic health record. Setting: The pediatric surgical unit and hematology/oncology unit of a free-standing, university-affiliated, urban children's hospital were selected to pilot this performance improvement project because of the high prevalence of pain from surgeries and hematologic and oncologic diseases, treatments, and invasive procedures. Results: Documentation of pain assessments, nonpharmacologic interventions, and evaluation of treatment effectiveness increased. The proportion of positive family satisfaction responses for pain management significantly increased from fiscal year 2014 to fiscal year 2016 (p = .006). Conclusion: By leveraging interactive patient care technologies, patients and families were engaged to take an active role in pain treatment plans and evaluation of treatment outcomes. Improved active communication and partnership with patients and families can effectively change organizational culture to be more sensitive to patients' pain and patients' and families' hospital experiences.