Date of Degree
Fall 2025
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Dr. Corinne Cochran
Abstract
Problem: Timely pain reassessment is a vital component of hospice care, directly influencing the quality of life for patients. Despite the high prevalence of pain, which affects 55% of hospice patients due to disease progression or adverse drug reactions, only 51% of those reporting moderate to severe pain at admission receive a documented reassessment. The gap highlights an organizational issue in pain management stemming from the absence of a clearly defined period and workflow for reassessment.
Aim of the Project: The aim of the quality improvement (QI) project was to improve compliance with pain reassessment documentation within 48 hours for hospice patients with moderate to severe pain by creating a standardized workflow to enhance symptom management and quality of care.
Review of the Evidence: Evidence-based practice confirms the necessity of ongoing pain assessment in patients receiving hospice and palliative care to optimize pain management and enhance patient outcomes. Timely pain reassessment maximizes the initiation and evaluation of pain control mechanisms, provides symptom relief, fosters clinician-patient communication, and improves patients’ overall experience.
Project Design: The Institute for Healthcare Improvement Model for Improvement guided the QI project, providing a structured framework for evaluating and refining changes through iterative Plan-Do-Study-Act (PDSA) cycles. The OhioHealth Change Management Model served as a guiding tool emphasizing the human and organizational aspects of change. The planning, connecting, and adopting phases of the model influenced activities leading to change.
Intervention: The project provided educational presentations to staff members on pain reassessment workflow, conducted change readiness surveys, and implemented EMR updates, real-time auditing, and a phased rollout of the implementation, guided by the Centers for Medicare and Medicaid Services (CMS) requirements.
Significant Findings/Outcomes: Data analysis revealed a 31% increase in documented pain reassessments within 48 hours. Staff confidence in using the workflow improved, and compliance with CMS pain-related measures increased by 78.6%.
Implications for Nursing: Establishing a structured workflow for pain reassessment in hospice care has significant implications for nursing practice. Reduced variation in clinical decisions and symptom management empowers nurses to be more accountable in providing patient-centered care and fosters a stronger nurse-patient relationship.
Recommended Citation
Omodara, Oluremi, "Implementing Pain Reassessment Workflow to Improve Timely Pain Management in Hospice Patients: A Quality Improvement Project" (2025). Doctor of Nursing Practice (DNP) Scholarly Project. 45.
https://fuse.franklin.edu/dnp-project/45
Rights
Copyright, all rights reserved
Included in
Other Nursing Commons, Palliative Nursing Commons, Public Health and Community Nursing Commons
