Time from Pain Assessment to Pain Intervention

OBJECTIVE The purpose of this study was to describe factors that influence nurses' time from pain assessment to intervention for acute postsurgical pain. BACKGROUND Nurses' time is a limited resource that must be optimized to manage patients' pain within budget constraints. Little is known about processes and activities nurses negotiate to manage pain. METHODS Human factors engineering and ethnography were used to quantify factors influencing time from pain assessment to intervention. RESULTS On the basis of 175.5 observation hours, nurses spent 11% of shifts (mean, 83 minutes) on pain care activities. Time from alert to intervention with PRN analgesics or biobehavioral strategies for 58 cases ranged from 0 to 48 minutes (mean, <11 minutes). Five factors influenced timeliness. CONCLUSIONS Nurses most efficiently managed postsurgical pain by giving analgesics ordered PRN on a scheduled basis. Nurse leaders can empower prompt responses to patients' pain through delegation, process improvements, real-time monitoring, and prescriber engagement.