Date of Completion
Open Access Capstone
Doctor of Nursing Practice (DNP)
Manu Thakral, PhD, NP
Diane Hanley, MS, RN, NPD-BC, EJD
Priscilla Gazarian, PhD, CNS, RN
Background: Evidence suggests that non-pharmacologic therapies complement and work synergistically alongside traditional pharmacologic therapies for chronic pain and have a beneficial impact on the intensity of pain, improved quality of life and functional status. Sickle Cell Patients have complex pain and often feel stigmatized due to pain seeking behaviors. This project evaluates the effect of a clinical initiative stewarded by nurses and managed in the electronic health record. The project aims to improve access to preferred modalities for integrative pain management among hospitalized Sickle Cell Disease (SCD) inpatients.
Methods: The nurses received e-learning and in-person training on the use of the chronic pain screening questions, care plan and orderset. They were asked to explore the impact of implicit bias on their nursing practice. Patients screening in for complex pain receive a brief interview to determine their preferences. The patient can request integrative nursing therapies and mulitdisiplinary consults from the team. The individualized integrative nursing therapies and multidisciplinary consults are delivered during the inpatient stay to the patient.
Analysis: The team will look at the patients that opted in to receive integrative therapies, nursing careplan and what consults they chose to receive and if the consults were completed during the admission. The knowledge and attitudes of the nurses will be evaluated through pre and post questions. The opinions and satisfaction of the patients will be assessed by survey prior to discharge. Post-implementation nurses will evaluate the usefulness and feasibility of the process.
Results: Nurses were open to assessing personal implicit bias and in utilizing strategies to mitigate bias. The vast majority of patients were interested in receiving the integrative therapies and multidisciplinary consults. The patients expressed high levels of satisfaction with nurse attention to their preference for care. Nurses rated the new program and documentation in the Electronic Health Record as feasible for use.
Conclusions: SCD patients who screened in for complex pain were interested in learning about integrative therapies and accessing them during inpatient hospital admission. Bedside nurses were impacted by working with patients as partners and sustainment of the program is planned with an ongoing Integrative Nursing Fellowship.
Lincoln, Nicole, "Improving Access to Non-Pharmacologic Integrative Pain Management Modalities in Sickle Cell Disease (SCD) inpatients" (2022). Doctor of Nursing Practice Scholarly Projects. 24.