@article {Kelly185, author = {Anne-Maree Kelly}, title = {A process approach to improving pain management in the emergency department: development and evaluation}, volume = {17}, number = {3}, pages = {185--187}, year = {2000}, doi = {10.1136/emj.17.3.185}, publisher = {British Association for Accident and Emergency Medicine}, abstract = {Aim{\textemdash}(1) To describe a process approach to the improvement of pain management in emergency departments. (2) To compare analgesia ordering and administration practices for patients with acute fractures before and after implementation of a nurse managed, titrated intravenous narcotic policy. Method{\textemdash}Retrospective chart review of patients with long bone fractures for the years 1993 and 1997. Results{\textemdash}There was a dramatic change in analgesia administration practices away from the intramuscular route in favour of the intravenous route (p\<0.001). For long bone fractures, in 1993, 53\% of patients received intramuscular narcotic analgesia compared with 5\% in 1997. In contrast, in 1993, 6\% of the patients received intravenous narcotic analgesia compared with 54\% in 1997. Conclusion{\textemdash}This study demonstrates that a process approach to improving pain management that resulted in both changes in drug administration and pain assessment and management processes made a significant and sustained change to analgesia ordering and administration practices for patients with long bone fractures in an emergency department.}, issn = {1351-0622}, URL = {https://emj.bmj.com/content/17/3/185}, eprint = {https://emj.bmj.com/content/17/3/185.full.pdf}, journal = {Emergency Medicine Journal} }