Therapy in Post Mastectomy Patients Sharp Memorial Hospital Short Stay Observation Unit Homa Shahabzadah RN MSN Student Elizabeth Isaacs BSN RN Advanced Clinician Susan ID: 931040
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Slide1
Pain Attenuation with Integrative Therapy in Post Mastectomy Patients
Sharp Memorial Hospital, Short Stay Observation Unit:
Homa Shahabzadah,
RN, MSN
Student;
Elizabeth
Isaacs, BSN, RN, Advanced Clinician;
Susan
Moore, MSN, RN, CNS
Slide2ObjectivesDetermine if nonpharmacologic therapies reduce painIdentify cost factors for pain therapies
Assess other benefits of
nonpharmacologic
therapies
Slide3Project Details452 bed hospital in southern CaliforniaInvestigators: MSN student
,
advanced clinician, and clinical
nurse specialist
Project origination:
I
nterprofessional
C
linical Practice
C
ouncil
Promoted integrative therapy use with conventional care
Study applied integrative therapy use for pain attenuation
Slide4BackgroundMastectomy patientsExperience pain Have social
and
psychological concerns
Require physical
rehabilitation
Opioid
epidemic
recognition in the USA Patients might refuse opioids leading to:Limitations in physical rehabilitationSymptoms of depression
Slide5Project FoundationThe Joint Commission – January 2018Hospitals must offer nonpharmacological pain therapiesRecognition of integrative modalities use in hospitals
Medications
Integrative Modalities
Slide6Integrative Therapies
Test group offered:
Aromatherapy
Music channel
Comfort hand massage
Slide7DemographicsAge 30-85Test Group: 30Control Group: 30Test group offered integrative therapies 24
hours post
operatively
Slide8Medication CostsCategory
Test Group
Control
Group
Average cost of meds per administration
$1.32
$2.27
Total cost of meds
$223.67
$515.22
Slide9Integrative Therapy CostsAromatherapy per treatment $0.09/eachMusic channel $0.00 Lotion use for comfort hand massage
$0.66
Slide10Unexpected OutcomesDecrease in:Medication costsStrength of pain medications
administered
Length
of
stay
Empowers patients to engage in self-care
Slide11Medications: Strength and Cost
Slide12Length of Stay
Slide13Pain Attenuation
Slide14Key Points for Integrative Therapy UseCategoryTest
Group
(30 patients)
Control Group
(30 patients)
Average length of stay (hours)
33.3
37.6
Total length of stay (hours)
998.7
1129.2
Average cost of
medication
$1.32
$2.27
Total cost of
medication
$223.67
$515.22
Average strength of opioids
administered (mme)
12.3
18.6
Total strength of opioids
consumed (mme)
2083.1
4225.7
Average RN visits to patients room for opioid
administration
5.6
7.4
Total RN visits to patients room for opioid
administration
169
223
Average level of pain at admit (scale 0-10)
3.8
3.2
Average level of pain at discharge (scale 0-10)2.22.6Average pain at start of pain treatment3.75.4Average pain after treatment1.41.4Average pain 4 hours later0.62.7
Decrease in:
Length
of
stay
Medication costs
Opioids received
Strength
of opioids
administered
Average
RN
administration frequency
of
opioids
Pain
level after four hours
Slide15ReferencesThe Joint Commission. (2018). Sentinel event alert: pain management. Retrieved December 8, 2018, from https://www.jointcommission.org/topics/pain_management.aspx U.S. Department of Health and Human Services. (2018, May 23). HHS acting secretary declares public health emergency to address national opioid crisis. Retrieved December 8, 2018, from https://www.hhs.gov/about/news/2017/10/26/hhs-acting-secretary-declares-public-health-emergency-address-national-opioid-crisis.html