Congress Abstracts 2004

50

PAIN RESOURCE NURSES, MORE THAN JUST A TITLE: ADVOCATES FOR CHANGE. Kathleen MacDonald, RN, BSN, OCN^®, Marilyn Sweeney, RN, BSN, OCN^®, and Linda Regul, RN, MSN, OCN^®, Fox Chase Cancer Center, Philadelphia, PA.

Pain continues to be a significant problem for patients with cancer. It disrupts physical and emotional well-being, affecting not only patients but also entire family units. The pain resource nurse (PRN) at this NCI-designated comprehensive cancer center, due to expert knowledge and experience in relation to pain and symptom management, is regarded as a patient advocate and educator to patients, caregivers, nurses, and physicians.

The role of the PRN is to provide a unit-based resource for effective pain and symptom management information. The PRN role is ongoing. It begins upon completion of the pain management instructional program and continues through quarterly meetings, providing PRNs with the latest pain-related information and the opportunity to discuss complex cases.

The role of PRNs as educators is accomplished through educational programs conducted throughout the year. Fall projects focus on patient and caregiver education, utilizing posters and information cards placed weekly on patients’ breakfast trays, covering diverse pain-related topics. Spring projects focus on staff education through the use of word games, awarding prizes to those units correctly answering the most questions. PRNs serve on various nursing and hospital committees, enlisting their pain management knowledge to influence policy revisions. PRNs were instrumental in recent medication kardex revisions promoting documentation of effectiveness of administered pain and symptom management medications per JCAHO standards. PRNs on the Quality Council established criteria for documentation of pain as the 5th vital sign in the medical record. Currently, PRNs are developing a pain competency checklist for registered nurses.

The success of the program can be measured not only by the requests for specific onsite clinical pain and symptom management consultation by the PRN, but also by the requests from network hospitals for assistance in the development of PRN programs. Press Ganey Patient Satisfaction data also indicate patient satisfaction with pain relief in the 99th percentile at our cancer center.

Across the continuum of care, PRNs accepting their role as advocates for change can improve the oncology patient’s quality of life by providing consultation and education to patients, families, and healthcare professionals, resulting in more effective pain and symptom management.