Get access

Translating Research into Practice Intervention Improves Management of Acute Pain in Older Hip Fracture Patients

Authors

  • Marita G. Titler,

    1. Research, Quality and Outcomes Management, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Room C529 GH, Iowa City, IA 52242,
    2. University of Iowa Hospitals and Clinics, Iowa City, IA,
    Search for more papers by this author
    • Address correspondence to Marita G. Titler, Ph.D., R.N., F.A.A.N., Director, Research, Quality and Outcomes Management, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Room C529 GH, Iowa City, IA 52242; e-mail: Marita-titler@uiowa.edu. Marita G. Titler, Ph.D., R.N., F.A.A.N., is also Senior Assistant Director, at the University of Iowa Hospitals and Clinics, Iowa City, IA. Keela Herr, Ph.D., R.N., F.A.A.N, Professor and Area Chair: Adult and Gerontology and Initiative Director for the John A. Hartford Center for Geriatric Nursing Excellence, is with the University of Iowa College of Nursing, Iowa City, IA. John M. Brooks, Ph.D., Associate Professor, is with the Program in Pharmaceutical Socioeconomics, University of Iowa College of Pharmacy, Iowa City, IA. Xian-Jin Xie, Ph.D., Assistant Professor of Biostatistics, Department of Clinical Sciences, and Director of Biostatistics Core, Simmons Comprehensive Cancer Center, is with the University of Texas Southwestern Medical Center, Dallas, TX. William R. Clarke, Ph.D., Professor, Biostatistics Core and Director, Clinical Trials Statistical and Data Management Center is with the University of Iowa College of Public Health, Iowa City, IA. Gail Ardery, Ph.D., R.N., Senior Research Assistant, is with the Clinical and Administrative Pharmacy, University of Iowa College of Pharmacy, Iowa City, IA. Margo L. Schilling, M.D., Clinical Associate Professor, is with the Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA. J. Lawrence Marsh, M.D., Professor, is with the Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA. Linda Q. Everett, Ph.D., R.N., F.A.A.N., Executive Vice President/Chief Nurse Executive, is with Clarian Health Partners, Indianapolis, IN.

  • Keela Herr,

    1. University of Iowa College of Nursing, Iowa City, IA,
    Search for more papers by this author
  • John M. Brooks,

    1. Program in Pharmaceutical Socioeconomics, University of Iowa College of Pharmacy, Iowa City, IA,
    Search for more papers by this author
  • Xian-Jin Xie,

    1. University of Texas Southwestern Medical Center, Dallas, TX,
    Search for more papers by this author
  • Gail Ardery,

    1. Clinical and Administrative Pharmacy, University of Iowa College of Pharmacy, Iowa City, IA,
    Search for more papers by this author
  • Margo L. Schilling,

    1. Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA,
    Search for more papers by this author
  • J. Lawrence Marsh,

    1. Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA,
    Search for more papers by this author
  • Linda Q. Everett,

    1. Clarian Health Partners, Indianapolis, IN
    Search for more papers by this author
  • William R. Clarke

    1. University of Iowa College of Public Health, Iowa City, IA,
    Search for more papers by this author

Abstract

Objective. To test an interdisciplinary, multifaceted, translating research into practice (TRIP) intervention to (a) promote adoption, by physicians and nurses, of evidence-based (EB) acute pain management practices in hospitalized older adults, (b) decrease barriers to use of EB acute pain management practices, and (c) decrease pain intensity of older hospitalized adults.

Study Design. Experimental design with the hospital as the unit of randomization.

Study Setting. Twelve acute care hospitals in the Midwest.

Data Sources. (a) Medical records (MRs) of patients ≥65 years or older with a hip fracture admitted before and following implementation of the TRIP intervention and (b) physicians and nurses who care for those patients.

Data Collection. Data were abstracted from MRs and questions distributed to nurses and physicians.

Principal Findings. The Summative Index for Quality of Acute Pain Care (0–18 scale) was significantly higher for the experimental (10.1) than comparison group (8.4) at the end of the TRIP implementation phase. At the end of the TRIP implementation phase, patients in the experimental group had a lower mean pain intensity rating than those in the comparison group ( p<.0001).

Conclusion. The TRIP intervention improved quality of acute pain management of older adults hospitalized with a hip fracture.

Ancillary