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  1. Seipel, Stacey L. MSN, RN, ONC
  2. Fulton, Megan Bales MPAS, PA-C
  3. McKinzie, Brian P. PharmD, BCPS, BCNSP
  4. Parnell, Lauren ATC-BOC


The trauma pain protocol was developed in response to nursing staff concerns regarding pain management practices and hospital-wide goals. Data collected on pain management practices within the trauma patient population identified inconsistencies with the transition of patient-controlled analgesia (PCA) to oral (PO) and intravenous (IV) pain medications. Nursing staff cited concerns with the frequent need for calls to clinicians to obtain additional pain medication orders following discontinuation of PCA. An interdisciplinary team developed a protocol to address appropriate PCA to PO/IV conversion, adjuvant medications, opioid reversal, and management of adverse effects. Data collected from a 4-month pilot of the protocol demonstrated a reduction in changes made to PO/IV medications following discontinuation of PCA. Nursing response to the protocol included increased satisfaction with pain management practices and a perception of time saved through reduced need for calls to clinicians for additional pain medication modifications. We conclude that this protocol results in a more individualized, evidence-based transition from PCA to PO/IV.