“…Underpinning both of these strands of activity is acknowledgement of the link between the delivery of timely and responsive nursing care and patient safety (Mitchell et al, ; Twigg, Myers, Duffield, Giles, & Evans, ). Attention to investigating the nature and impact of these 2 broad forms of rounding highlight that both basic (Alaloul et al, ; Blakley et al, ) and expert nursing care (Catangui & Slark, ) is linked to patient safety and improved patient outcomes.…”
There has been continued interest in nurse rounding and its potential benefits. However, poor definitional clarity is evident in this body of research, with various label used interchangeably in studies reporting similar rounding designs. The field would benefit from improved conceptual clarity and investigation into forms of nurse rounding that remain largely unexamined.
“…Underpinning both of these strands of activity is acknowledgement of the link between the delivery of timely and responsive nursing care and patient safety (Mitchell et al, ; Twigg, Myers, Duffield, Giles, & Evans, ). Attention to investigating the nature and impact of these 2 broad forms of rounding highlight that both basic (Alaloul et al, ; Blakley et al, ) and expert nursing care (Catangui & Slark, ) is linked to patient safety and improved patient outcomes.…”
There has been continued interest in nurse rounding and its potential benefits. However, poor definitional clarity is evident in this body of research, with various label used interchangeably in studies reporting similar rounding designs. The field would benefit from improved conceptual clarity and investigation into forms of nurse rounding that remain largely unexamined.
“…The script was created by the nurses who worked in perioperative services and was patterned after a script found in the literature (Alaloul et al., ). Specifically, the nurses said: Here at [our hospital], we are very concerned with your pain control management during your stay with us.…”
Section: Methodsmentioning
confidence: 99%
“…Script-based communication has been shown to help nurses deliver clear, consistent, and essential messages in health care. Those messages include communication that healthcare providers are aware of patients' needs, are caring for their suffering, and are working hard to keep them as comfortable as possible (Alaloul, Williams, Myers, Jones, & Logsdon, 2015). Consistent communication has shown a positive effect in patient satisfaction with pain management (Alaloul et al, 2015) and pain management scripting may assure an open flow of communication between patients and healthcare providers (Mitchell, 2015).…”
Section: Scriptingmentioning
confidence: 99%
“…The script was created by the nurses who worked in perioperative services and was patterned after a script found in the literature (Alaloul et al, 2015). Specifically, the nurses said:…”
A scripted message showed statistical significance and a small clinical effect in pain control that adds to the body of knowledge around the effectiveness of scripting delivered by nurses. Although it is encouraging that even the small dose of scripting had a significant effect on postoperative pain control, the feasibility issues around similar study designs will require considerable resources to surmount. Practice change is a complex process requiring sensitivity to work and patient flow especially in specialty care units. Resistance to change when evidence is not robust may be especially difficult related to scripting, often perceived as a mandated intrusion into the nurse-patient relationship.
“…Patient questionnaires are useful for measuring the behavioral skills of team members and the quality of patient care 19,20. Therefore, a questionnaire survey in groups “before” and “after” CICARE was conducted anonymously to investigate whether implementing CICARE through SOP for the APS team improved communication skills, PGI-Improvement in pain and patient satisfaction in patients receiving postoperative IV-PCA 17,21.…”
PurposeThis study aimed to evaluate whether a nonpharmacological approach through implementation of a communication improvement program (named CICARE for Connect, Introduce, Communicate, Ask, Respond and Exit) into standard operating procedure (SOP) in acute pain service (APS) improved satisfaction in patients receiving intravenous patient-controlled analgesia (IV-PCA).Patients and methodsThis was a nonrandomized before–after study. Adult patients (aged between 20 and 80 years) who received IV-PCA after major surgery were included. Implementing CICARE into SOP was conducted in APS. Anonymous questionnaires were used to measure outcomes in this prospective two-part survey. The first part completed by APS nurses contained patients’ characteristics, morphine dosage, delivery/demand ratios, IV-PCA side effects and pain at rest measured with an 11-point numeric rating scale (NRS, 0–10). A score of NRS ≥4 was defined as inadequately treated pain. The ten-question second part was completed by patients voluntarily after IV-PCA was discontinued. Each question was assessed with a 5-point Likert scale (1: extremely poor; 5: excellent). Patients were separated into “before” and “after” CICARE groups. Primary outcomes were patient global impression of improvement in pain (PGI-Improvement) and patient satisfaction. Secondary outcomes included quality of communication skills, instrument proficiency and accessibility/availability of IV-PCA.ResultsThe response rate was 55.3%, with 187 usable questionnaires. CICARE effectively improved patient global impression of improvement in pain, patient satisfaction, communication skills and accessibility/availability of IV-PCA. No significant differences were noted in instrument proficiency, morphine dosage, delivery/demand ratios, rates of inadequately treated pain at rest and side effects of IV-PCA between groups. Paradoxical findings were noted between the rates of inadequately treated pain/side effects and PGI-Improvement in pain/patient satisfaction, which were affected by psychological factors.ConclusionNonpharmacological interventions carried out by implementing CICARE into SOP for APS effectively improved patient satisfaction and postoperative pain management quality, but this did not affect actual pain.
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