• Adv Emerg Nurs J · Apr 2017

    Application of Primary Care Guideline for Chronic Low Back Pain in the Emergency Department.

    • Rebeca M Tacy, Sherry Donaworth, and Kathleen Ballman.
    • Thomas More College, Crestview Hills, Kentucky, (Dr Tacy); and University of Cincinnati College of Nursing, Cincinnati, Ohio (Drs Donaworth and Ballman).
    • Adv Emerg Nurs J. 2017 Apr 1; 39 (2): 123-140.

    AbstractChronic low back pain (CLBP) is a primary care condition that overflows into the emergency department (ED). No ED-specific practice guideline exists for the management of patients with CLBP in the ED setting. Back pain is a common chief complaint, with cases of CLBP making up to 50% of the patients seen with back pain in an urban, freestanding ED affiliated with a multicampus health system in the Midwest where 25% of patients live below the poverty line and 21.8% do not have primary care. Kolcaba's Theory of Comfort guides the implementation of an evidence-based practice application project. The Guideline for the Evidence-Informed Primary Care Management of Low Back Pain from the National Guideline Clearinghouse is introduced. Interprofessional collaboration for immediate referrals was implemented. The plan-do-study-act model was applied with descriptive analysis of the data. Reflective of established specific aims of the project, there was increased (1) support for the use of evidence-based practice guideline among the ED providers and staff, (2) use of evidence-based practices, (3) connection of patients to community resources, (4) evidence-based education for patients, and (5) overall satisfaction with pain management. The effectiveness of the application of this primary care guideline in the ED opens the way both for region-wide application of the guidelines and for the introduction of other primary care practice guidelines for patients who present to the ED with other chronic conditions.

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