Keywords

30-Day readmission, African American adult, length of stay, NP-led acute pain service, nurse practitioner, pain management, sickle cell disease

 

Authors

  1. Macey-Stewart, Karen V. DNP, APN, A-GNP-C, RN-PMGT-BC (Intermin Traditional BSN Practice Director)

ABSTRACT

Background. The increased lifespan of individuals having sickle cell disease (SCD) causes an overall increase in hospitalizations and more instances in which pain may not be well controlled.

 

Local problem. The mainstay treatment for severe pain is opioids and the underlying cause. Laws affecting opioid prescribing, implicit bias, racial inequity, poor research funding, and lack of knowledge contribute to poor patient outcomes.

 

Method. Data were collected retrospectively using electronic medical record data from before and after the intervention.

 

Intervention. The individualized pain management plan (IPMP) was initiated in collaboration with the patient, pain nurse practitioner (NP), and hematologist.

 

Result. The mean length of stay for the traditional pain management plan (TPMP) was 7.89 days compared with 5.66 days for the IPMP, with a mean difference of 2.23 days, t = 2.278, p = .024 (p < .05). There was a decrease in the admission of the individuals with the IPMP, with 25% readmitted within 30 days of discharge, versus 59.0% who were readmitted using the TPMP. Chi-square showed statistical significance ([chi]2 = 61.667, p = .000) in using nonpharmacological interventions with the IPMP group.

 

Conclusion. The IPMP with a patient-centered approach did improve patient outcomes for African American adults living with SCD.