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Nursing Leadership in Pain Management: Implementing the Pain Resource Nurse Role

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Nursing Leadership in Pain Management: Implementing the Pain Resource Nurse Role Salima S. J. Ladak, RN, MN-ACNP Coordinator, UHN APN Pain Network – PowerPoint PPT presentation

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Title: Nursing Leadership in Pain Management: Implementing the Pain Resource Nurse Role


1
Nursing Leadership in Pain Management
Implementing the Pain Resource Nurse Role
  • Salima S. J. Ladak, RN, MN-ACNP
  • Coordinator, UHN APN Pain Network

2
Pain 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

3
Role 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.

4
Focus Group Outline
  • Research Ethics Board Approval
  • Funded by the Krembil Foundation
  • Guiding Research Question
  • How did implementation of the PRN role at UHN
    work?

5
Literature 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)

6
Method
  • 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

7
Participant 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)

8
Participant 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

9
Focus 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.

10
Describe 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

11
Describe what contributes to role clarity for
PRNs at UHN.
  • Leadership support on unit
  • Support from Pain Management Advance Practice
    Nurse

12
Describe 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

13
Describe future role expectations and role
development needs of PRNs at UHN
  • Additional time
  • More educational opportunities
  • Increased human resource capacity
  • Improved role awareness

14
Outcome Next Steps
  • Develop content outline for next cycle of PRN
    Program based on feedback
  • Consider sustainability strategies
  • Disseminate findings through publications
    presentations

15
UHN 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
16
Co-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

17
  • THANK YOU !
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