Process Improvement and Change Project

Order Details

CHANGE PROJECT TOPIC: PAIN CONTROL AND MANAGEMENT IN THE INPATIENT REHABILITATION UNIT.
HOSPITAL INVOLVED: KECK HOSPITAL OF UNIVERSITY OF SOUTHERN CALIFORNIA (USC)
NURSING UNIT: INPATIENT REHABILITATION UNIT
(Unit that Rehabilitates patients post surgical spine, head, hip, knee, procedures and stroke patients. Requires 3 hours of Physical Therapy, Occupational Therapy and Speech Therapy daily)
PLEASE INCLUDE SPEAKER NOTES.
1) Introduction (regarding pain management, control, addiction, tolerance, and myths for status post spine surgery, craniotomy, hip and knee replacement surgery, and stroke patients)
2) Identification of problem or process to be changed. (problem: Patients pain are not being well controlled, patients are not able to tolerate rehabilitation which requires 3 hours per day with Physical, Occupational, and Speech Therapy. Patients that do receive adequate pain control are too lethargic and drowsy during therapy times. Patients are being deemed to be addicted or dependent to pain medication. Patients are being looked at drug seekers instead of being given appropriate pain medication)
3) Need for the change or enhancement, including driving forces such as:
o Regulatory, such as OSHA mandate
o Benchmarking
o Improved efficiency
o Patient satisfaction (Based on surveys post discharge from the hospital)
o Life safety issue
4) Timeline (of change or steps to be taken in order for change to occur)
5) Methodology used (to implement change on the Rehabilitation unit including education for Doctors, Directors, Nurse Managers, Charge nurses, Registered Nurse, Nursing Assistants, Physical Therapy, Occupational Therapy and Speech Therapy)
6) Change theorist (ROGER’S THEORY Five Step Process) and leadership style (Charles Darwin) that are incorporated as a motto or mantra for change to occur in the unit.
7) Research literature to support proposed change process. (Literature based on pain control and pain management)
8) PDAC (PLAN, DO, ACT, CHECK) cycle, Extensive education, interdisciplinary approach, implementation strategies, and evaluation process
9)Summary
10)REFERENCE
Summary of change project:
Working at Keck Hospital of USC in the Inpatient Rehabilitation Unit. Patients come to the unit in great amount of pain after surgical procedures such as spine, neck, head, hip, knee surgeries). Some patients are not able to tolerate a 3 hour therapy session with physical, occupational, and speech therapy due to pain. Medical doctors feel that patients are either dependent, addicted or are drug seekers hence pain is not managed well. Medical Doctors also do not want patients to have a large dose of pain medication because it impedes participation of patient for therapy. In result patients are being under medicated and to tolerate with pain at more than 5/10 on the pain scale during and after therapy. Most of the pain felt are muscular soreness from surgery and some are nerve pain that can only be resolved with medication such as gabapentin/neurontin. The objective/goal of this change project is for patient to be satisfied with their stay in Rehab, change in culture, change geared towards evidence-based practice. Patients need to be able to participate in therapy with pain that is tolerable at 2/10 on they pain scale. Along with the whole hospital to be more aware of pain control and management for the patients.

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