• patient controlled oral medication

Poster Presentation

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  2. Poster Presentation

Purpose for the Program

To increase our hospital's low patient satisfaction scores in the area of “How well was your pain controlled?” from the Press Ganey survey.

Proposed Change

The proposed change to patient controlled oral medication (PCOM) for analgesia was developed by a task force of nurses and pharmacists in collaboration with physicians, information technology staff, regulatory nurses from the Quality Department, Risk Management, Forms Committee, Education Council, Practice Council, and Leadership Council.

Implementation, Outcomes, and Evaluation

The implementation of this initiative began with a pilot program that lasted 1 month.  When a patient who is about to deliver arrives in the labor and delivery unit, an obstetric assessment is completed by a registered nurse (RN), including patient screening. The patient is asked if she is able and wants to participate in PCOM. Postpartum, the physician orders ibuprofen PCOM. Upon arrival to the postpartum wing, the RN explains PCOM, the flow sheet, and documents. The outcome of this pilot program was a survey of RNs and patients using the PCOM. The PCOM program was re-examined taking into consideration concerns from both surveys. We began the initiative again in 2010 with a few changes suggested by the nurses and patients. We used the Press Gainey survey to evaluate the program. In October 2010, our score for “How well was your pain controlled?” was 82.0. Seventeen months after implementation of the PCOM program in March 2012, our score was 90.9, 99% in ranking with like hospitals.

Implications for Nursing Practice

The implementation of a patient controlled oral pain management program allows the patient and the nurse to partner in pain management following delivery. The patient has ready access to pain medication and is able to manage medications based on her specific situation and needs.