Creating organizational change through the Pain Resource Nurse program.
BACKGROUND: Unrelieved pain remains a critical problem in health care. Barriers to improving the state of pain control include lack of education of health care professionals. Traditional quality improvement (QI) strategies directed toward educational interventions are rarely sufficient to change pain-related practice. PAIN RESOURCE NURSE (PRN) PROGRAM: The PRN program consists of a two-day course, quarterly in-services, regular newsletters, a listserv, individual meetings with PRNs and their managers to plan and conduct quality initiatives appropriate to their unit, as well as an optional clinical experience. RESULTS: Significant improvements were seen in knowledge and attitude of the participants, along with reduced turnover, improved patient satisfaction with pain control, a reduction in the prevalence of pain, and a greater percentage of patients who remembered speaking with a doctor or nurse about their pain (93% versus 89%). DISCUSSION: Establishing a PRN program entails conquering a number of management challenges common to any organizationwide QI project. The single most important step is building a shared priority among all those who must participate for success-in this case, nursing management. SUMMARY: The PRN program is an effective strategy in creating organizational change to improve the state of pain control.