IMPLEMENTING NATIONAL STANDARDS FOR CANCER PAIN MANAGEMENT - PROGRAM MODEL AND EVALUATION

The purpose of this quasi-experimental (pre- and posttest) study was t o test a model pain management program (PMP) to implement the American Pain Society (APS) quality assurance standards far the management of acute and chronic cancer pain using a continuous quality improvement ( CQI) approach to improve professionals' knowledge and skills, patient satisfaction, and to identify areas needing improvement. The sample co nsisted of 1210 nurse responses and 698 interviews of patients with pa in during hospitalization at a major urban cancer center The PMP provi ded a structure (standards), educational opportunities, and training i n CQI methods. Outcome measures included a patient evaluation question naire and concerns checklist; nurse knowledge, attitude and barriers q uestionnaire; and focus groups to identify areas needing improvement. Significant improvements were found in patients' satisfaction, nurses' knowledge and attitude scores, and reductions in nurses' perceptions of barriers. Focus groups revealed the need for improved communication among disciplines about pain and better assessment of patients unable to self-report. The program met its goal of implementing the APS stan dards, educating nurses, and identifying ''system'' problems, and impr oving overall patient satisfaction. (C) U.S. Cancer Pain Relief Commit tee, 1996.