Comparison of Pain Management between before and after the Application of Guidelines in Cancer Emergency Room

Young Hwa Won; Yeon Hee Kim; Jeong Yun Park

doi:10.5388/aon.2012.12.3.230

Journal List > Asian Oncol Nurs > v.12(3) > 1081738

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Won, Kim, and Park: Comparison of Pain Management between before and after the Application of Guidelines in Cancer Emergency Room

Original Article

Asian Oncology Nursing

Asian Oncology Nursing 2012; 12(3): 230-236.

Published online: 30 September 2012

DOI: https://doi.org/10.5388/aon.2012.12.3.230

Comparison of Pain Management between before and after the Application of Guidelines in Cancer Emergency Room

Young Hwa Won¹, Yeon Hee Kim¹, Jeong Yun Park²

¹Department of Nursing, Asan Medical Center, Seoul, Korea.

²Department of Clinical Nursing, University of Ulsan, Ulsan, Korea.

Address reprint requests to: Kim, Yeon Hee. Department of Clinical Nursing, Asan Medical Center, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-2080, Fax: +82-2-3010-2080, kimyhee@amc.seoul.kr

Received 23 August 2012 Accepted 21 September 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was to investigate the effect of the application of cancer pain management guidelines on pain management among patients in Cancer Emergency Room.

Methods

This study was a retrospective descriptive study. Before application, data were collected by analyzing the Electronic Medical Record in Cancer Emergency Room in September, 2011, and after application in February, 2012. The subjects of this study consisted of 231 patients (pre-application group 83, post-application group 148), who stayed over 24 hours and complained of pain higher than Numeric Rating Scale score 4. The post-test was conducted after educating the nurses about the application of the pain management guidelines in the Electronic Medical Record.

Results

This survey showed that, as the cancer pain management guidelines were applied for cancer patients with above moderate pain, the pain intensity decreased, the number of patients reaching the treatment goal score increased. Furthermore, the estimated time to reach the treatment goal decreased significantly.

Conclusion

Pain intensity of the cancer patients was decreased through regular pain assessments by nurses and the medication of analgesics according to the cancer pain management guidelines. Therefore, it is necessary to develop the pain management program and to provide the physicians and nurses with intensive education about the pain management guidelines for systematic and effective pain management.

Keywords: Neoplasms, Pain, Practice Guideline, Emergency Hospital Service

Figures and Tables

Fig. 1

Data collection.

CER=Cancer emergency room; NRS=Numeric rating scale; EMR=Electronic medical records.

Fig. 2

Kaplan-Meier survival curves comparing "Time to reach treatment goal score" between before and after application of cancer pain management guideline (p<.001 Kaplan-Meier analysis).

Table 1

Characteristics by Pain Management Guideline Application

^*Solid tumor: lung, stomach or colorectal, hepatobillary organ, breast, genitourinary; ^†Hematologic malignancy: leukemia, lymphoma, myelodysplastic syndrome; ^‡Multiple choices.

NRS=Numeric rating scale; OME=Oral morphine equivalent.

Table 2

Pain Control by Pain Management Guideline Application

^*Except missing.

NRS=Numeric rating scale; CER=Cancer emergency room; OME=Oral morphine equivalent.

Table 3

Compliance Rate of Pain Management by Guideline Application

Notes

This article is a revision of the first author's master's thesis from Ulsan University.

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