• A Holzheimer, S C McMillan, and M Weitzner.
• College of Nursing, University of South Florida, USA.
• Oncol Nurs Forum. 1999 Oct 1; 26 (9): 1499-504.

Purpose/ObjectivesTo evaluate the success of a multifaceted, hospicewide, nurse-focused pain-management intervention for improving patient pain outcomes.DesignComparative, descriptive.SettingA large, nonprofit hospice that primarily provides home care.SampleTwo samples were included in the study. One sample (n = 47) was from a study completed in 1995 before the intervention, and one (n = 255) was from a study completed in 1997 after the intervention. All patients had been diagnosed with cancer and were alert and able to self-report.MethodsSecondary analysis of data that were collected as part of two quality-of-life studies. The four-part intervention included intensive pain-management education for the nurses, development and implementation of pain-management policies and procedures, changes in pain assessment and management documentation, and development and use of quality assurance monitors by the nursing staff.Main Research VariablesPain at its worst, pain relief, and quality of life.FindingsAdjusted mean pain-relief scores were significantly lower in 1995 (X = 5.8) than in 1997 (X = 8.4). In 1995, 43% of patients reported pain relief at a level of 5 or less (on a 0-10 scale). This number dropped to 10% by 1997. Adjusted mean pain-at-its-worst scores were significantly lower in 1997 (X = 6.1) than in 1995 (X = 6.7). Pain relief was found to be positively correlated (r = 0.41-0.51) with quality of life in both samples.ConclusionsThe hospicewide pain-management intervention was effective.Implications For Nursing PracticeThrough careful study and multifaceted nurse-focused interventions, pain outcomes of hospice patients with cancer can be improved.

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