ABSTRACT
PURPOSE: The purpose of this article is to describe barriers to cancer pain management and strategies for making improvements in an academic rural cancer center. OVERVIEW: Rural communities pose unique challenges to cancer pain management because of their unique strengths and burdens. Successful strategies used by a comprehensive cancer center to improve pain management in rural New England are summarized. CLINICAL IMPLICATIONS: Improving cancer pain management in a rural setting required a recognition of the contrasting characteristics between a sophisticated academic medical center and a rural community. The successful implementation of quality improvement strategies required a combination of leadership support, internal and external funding, and professional and federal recognition of the problem. Using a quality improvement approach rather than a traditional didactic approach, and fostering communication, trust, and collegiality at our outreach sites were pivotal to our success.
Subject(s)
Cancer Care Facilities/standards , Pain Management , Rural Health Services/standards , HumansABSTRACT
OBJECTIVES: To use quality improvement methodology to improve the assessment and treatment of neuropathic pain caused by chemotherapy-related nerve injury. DATA SOURCES: Review and research articles, assessment scales, and textbooks. CONCLUSIONS: Assessment and treatment algorithms improved peripheral neuropathy-related pain scores. Patient satisfaction with medication effectiveness decreased over time. Medication costs increased, but specialist-referral costs decreased. IMPLICATIONS FOR NURSING PRACTICE: Nurse-led quality improvement work can lead to positive changes in clinical practice.
