Doctor of Nursing Practice
Kerry Milner, DNSc, APRN, FNP-BC, EBP-C
Miwa Saito, MSN, RN; Practice Expert
Second Practice Mentor
Vanessa Tran, BSN, RN
Background: Best practices include assessing functional status in addition to pain intensity in patients with cancer experiencing pain. The Defense and Veterans Pain Rating Scale (DVPRS) is an effective tool for assessing pain intensity and functional status in patients with cancer.
Objective: To improve pain assessment among outpatient oncology patients in an adult cancer center by implementing the DVPRS and evaluating patient and nurse satisfaction with this tool.
Methods: The Model for Healthcare Improvement was followed for the planning, implementation, and evaluation of this project. Nurses completed an online education module and self-assessment quiz before an in-person simulation checkoff demonstrated their correct use and documentation in the EHR of the DVPRS. Weekly audits of the electronic health record (EHR) for DVPRS use and documentation were done. Patient satisfaction was measured after each use of the DVPRS. Nurse satisfaction with the DVPRS was measured at the end of the 5-week pilot.
Results: Ten of 12 (83%) nurses completed the DVPRS education and simulation check-off. The pilot was from February 13, 2023, to March 17, 2023. Documentation of DVPRS use was zero in the first two weeks. A midcycle assessment resulted in giving the nurses real-time reminders to use the DVPRS, and where and how to document its use in the EHR. Weeks three through five showed a steady increase in DVPRS use with 3 (15%), 5 (20%), and 8 (40%), respectively. Patient satisfaction was recorded by five patients in week 4 only with a mean score of 6.6 indicating a positive experience. In week five, nurse satisfaction was recorded by 7 (70%) nurses with a mean score of 3.62 indicating neutral/agreement with the DVPRS use.
Conclusions: Adoption of the DVPRS to assess pain and functional status in this outpatient adult oncology center was limited. When the DVPRS was used, patients were satisfied. For the next cycle of change nurse buy-in should be evaluated and having APRNs and MDs assess patients’ pain using the DVPRS should be part of the process improvements.
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Pantchenko, K. (2023). Implementation of a functional pain scale in an adult cancer center [Unpublished DNP project]. Sacred Heart University.
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.