Title: Nursing Leadership in Pain Management: Implementing the Pain Resource Nurse Role
1Nursing Leadership in Pain Management
Implementing the Pain Resource Nurse Role
- Salima S. J. Ladak, RN, MN-ACNP
- Coordinator, UHN APN Pain Network
2Pain Resource Nurse Program
- Goal Improve pain management practices at UHN
- Select group of RNs received 4-day educational
program in addition to time with APN Mentor in
Pain Management
3Role Description
- A Pain Resource Nurse functions as a nursing
clinical expert, peer consultant, role model,
resource and change agent in the prevention and
management of physical, emotional and
psychological pain in collaboration with the
multidisciplinary team, patients and their
families.
4Focus Group Outline
- Research Ethics Board Approval
- Funded by the Krembil Foundation
- Guiding Research Question
- How did implementation of the PRN role at UHN
work?
5Literature Review
- One educational intervention not effective for
knowledge transfer (Dalton et al, 1996) - Role-model programs show more promise and have
demonstrated changes in knowledge and attitudes
up to 12 months later (Sterman, Gauker Krieger,
2003) - Pediatric PRN Program indicated PRNs functioned
as communicator, coach/mentor, troubleshooter and
provided feedback to staff on pain management
practice (McCleary et al 2004)
6Method
- Roys adaptation model as theoretical framework
(PRN role function as adaptation to a change in
the professional nursing role) - Qualitative descriptive study using open ended
focus group questions - Convenience sampling from each site
- Interviews tape recorded and transcribed by RA
7Participant Demographics (N 21)
- 90 Female
- 10 Male
- Years worked at UHN 12.3
- Years in Nursing profession 17.2
- Employment status
- Part time 2 PRNs (9)
- Full time 19 PRNs (91)
8Participant Demographics Contd
- Education
- Diploma 8 (38)
- Bachelors Degree 9 (43)
- No response 4 (19)
- Previous Leadership Positions
- 3 PRNs No
- 18 PRNs Yes
- Eg Unit Council, Charge RN, Care Leader
9Focus Group Analysis
- Objectives
- Describe role expectations of the pain resource
nurses at UHN. - Describe what contributes to role clarity for
PRNs at UHN. - Describe role conflict with the PRN role at UHN.
- Describe future role expectations and role
development needs of PRNs at UHN.
10Describe role expectations of the pain resource
nurses at UHN
- Function as a resource in a leadership role for
staff and further pain management knowledge - Patient advocacy
- Resource for clinical decision making
11Describe what contributes to role clarity for
PRNs at UHN.
- Leadership support on unit
- Support from Pain Management Advance Practice
Nurse
12Describe role conflict with the PRN role at UHN
- Confusion about scope of practice
- Interdisciplinary team integration
- Lack of awareness of the PRN role
- Lack of time, human resources
13Describe future role expectations and role
development needs of PRNs at UHN
- Additional time
- More educational opportunities
- Increased human resource capacity
- Improved role awareness
14Outcome Next Steps
- Develop content outline for next cycle of PRN
Program based on feedback - Consider sustainability strategies
- Disseminate findings through publications
presentations
15UHN Patient Satisfaction
Significant increase at p0.001
UHN FY 04-05 89.4
Data Source NRC Picker Patient Satisfaction, UHN
Total July 2003-March 2004 (N4,075) April
2004-August 2006 (N13,085) Score Yes,
definitely 100, Yes, somewhat 50, No 0 UHN
Methodology
16Co-Investigators
- Nahed al Baba
- Allyson Clarke
- Marleine Elkhouri (UHN)
- Patti Kastanias (UHN)
- Carolyn McPhee (UHN)
- Meredith Muscat (UHN)
- Sandra Robinson (UHN)
- Cindy Shobbrook (UHN)
- Kianda Snaith
- Linda Turner
- Baiba Zarins (UHN)
- Special thank you to our Research Assistant
- Anna Buss
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