Changing pain management practice and impacting on patient outcomes.

Concerns about acute pain management prompted the development of a pain management program. The program, with assessment, intervention, and evaluation components, was introduced by the clinical nurse specialist (CNS) in collaboration with a multidisciplinary team. The assessment phase included a descriptive study of postoperative pain and a baseline audit of nursing documentation related to pain assessment and management. Interventions, including a focused educational program and new routes for postoperative analgesia, were then introduced. Evaluations at 3 months and 2 years indicated improvements in documentation of pain assessments and improved management of pain. Additionally, at each follow-up evaluation, patients reported decreased postoperative pain. The assessment and management of pain is an important domain of nursing practice. The CNS is in a unique position to influence nursing practice and to impact on patient outcomes in this area of pain management.