Does e-pain plan improve management of sickle cell disease associated vaso-occlusive pain crisis? A mixed methods evaluation

Kato-Lin, Yi-Chin; Krishnamurti, Lakshmanan; Padman, Rema; Seltman, Howard

doi:10.1016/j.ijmedinf.2014.08.003

Cited by 12 publications

(14 citation statements)

References 32 publications

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“…Our post‐intervention admission rate of 41% is lower that what has been previously reported in the literature. Previous studies of VOC in children have reported admission rates between 50 and 78% . We estimate that 49 admissions and 307 inpatient days are avoided annually through the initiative.…”

Section: Discussionmentioning

confidence: 97%

“…We found the high admission rates for patients presenting with VOC both locally (50–57%) and nationally (50–78%) to be unacceptable. At our center, we observed an inconsistent approach to pain management both in the ED and after admission.…”

Section: Introductionmentioning

confidence: 84%

“…Previous studies of VOC in children have reported admission rates between 50 and 78%. [4][5][6][7] We estimate that 49 admissions and 307 inpatient days are avoided annually through the initiative. We also demonstrated an association between shorter time to receiving a second dose of opiate and decreased likelihood of admission.…”

Section: Discussionmentioning

confidence: 99%

“…Several strategies have been attempted to reduce the burden of VOC through standardizing care. Standardized care pathways have previously been shown to improve time to first opiate dose, increased ketorolac use, and pain scores, but most have not reduced admission rate . Attempts have also been made to individualize care for these children.…”

Section: Introductionmentioning

confidence: 99%

“…Standardized care pathways have previously been shown to improve time to first opiate dose, increased ketorolac use, and pain scores, but most have not reduced admission rate. 4,5 Attempts have also been made to individualize care for these children. One study showed a reduced admission rate with the use of individualized pain plans (IPPs).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

A novel approach to reducing admissions for children with sickle cell disease in pain crisis through individualization and standardization in the emergency department

Schefft

Swaffar

Newlin

et al. 2018

Pediatric Blood & Cancer

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A novel approach to reducing admissions for children with sickle cell disease in pain crisis through individualization and standardization in the emergency department

Schefft

Swaffar

Newlin

et al. 2018

Pediatric Blood & Cancer

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Human Factors Engineering: Status, Interventions, Future Directions in Pediatrics

Ponnala

Rivera

2019

Curr Treat Options Peds

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Exploring Emergency Department Provider Experiences With and Perceptions of Weight-Based Versus Individualized Vaso-Occlusive Treatment Protocols in Sickle Cell Disease

Knight

Onsomu²,

Bosworth

et al. 2019

Advanced Emergency Nursing Journal

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Introduction: Treatment of vaso-occlusive episodes (VOE) are the most common reason for ED treatment of sickle cell disease (SCD). We 1) compared perceptions of the usability and ability to manage VOE pain between ED nurses and other ED provider types, ED sites, and VOE protocols (individualized versus weight-based), and 2) identified ED nurse and other provider protocol suggestions. Methods: A secondary analysis of provider survey data collected immediately after caring for a patient enrolled in a randomized control trial comparing weight based vs. individualized opioid dosing for VOE. Research staff asked the ED nurse and other ED providers (nurse practitioners [NPs], physician assistants [PAs], residents and attending physicians) five questions related to the protocol’s ease of use and ability to manage pain. Results: There were 236 surveys completed. Attending physicians (n=15), residents (n=88), PAs (n=21), and NPs (n=1) were more satisfied than nurses (n=111) with the clarity of the analgesic ordering (97.6% vs. 0%, p = 0.0001), and ability to manage the patient’s VOE pain (91% vs. 0%, p = 0.0001). When comparing both protocols with the usual ED strategy in their ED to manage VOE, more nurses than other ED providers perceived the study patients’ pain management protocol as better (100% vs. 35.2%, p = 0.0001).Other ED providers perceived the individualized versus weight-based protocol as better at managing pain than their usual ED strategy (70.3% vs. 59.5%, p = 0.04). Conclusion: The individualized protocol was perceived as better in managing VOE than the weight-based ED strategy. While physicians were satisfied with the clarity of the protocols, nurses were not. Improved protocol usability is required for widespread ED implementation.

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Does e-pain plan improve management of sickle cell disease associated vaso-occlusive pain crisis? A mixed methods evaluation

Cited by 12 publications

References 32 publications

A novel approach to reducing admissions for children with sickle cell disease in pain crisis through individualization and standardization in the emergency department

A novel approach to reducing admissions for children with sickle cell disease in pain crisis through individualization and standardization in the emergency department

Human Factors Engineering: Status, Interventions, Future Directions in Pediatrics

Exploring Emergency Department Provider Experiences With and Perceptions of Weight-Based Versus Individualized Vaso-Occlusive Treatment Protocols in Sickle Cell Disease

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