A Comprehensive Approach to Improving Cancer Pain Management and Patient Satisfaction

857 Cancer is diagnosed in more than 1,334,000 Americans annually (Jemal et al., 2003). Pain is experienced by 30%–50% of patients with cancer receiving treatment and by 70%–90% with advanced cancer (Portenoy, 1989). Estimates of pain in hospitalized patients with cancer have been reported to be as high as 90% (Brescia, Portenoy, Ryan, Krasnoff, & Gray, 1992; Jadlos, Kelman, Marra, & Lanoue, 1996; Oden, 1989). Although guidelines for the management of pain have been published, patients continue to experience pain despite these management regimens. Furthermore, a variety of studies of patient populations have confirmed that inadequate pain management exists (Bonica, Ventafridda, & Twycross, 1990; Brescia et al.; Jadlos et al.; McMillan & Tittle, 1995). A four-year study of 9,000 terminally ill patients in five teaching hospitals revealed that 50% of conscious patients who died in the hospital experienced moderate to severe pain at least half of the time (SUPPORT Principle Investigators, 1995). The purpose of this article is to describe the development and evaluation of a comprehensive nursing pain management performance improvement program. An initial pain audit was conducted on a 19-bed inpatient medical oncology unit two months prior to the implementation of the performance improvement program. Data were collected using ongoing medical record audits and the Patient Satisfaction Pain Survey (see Figure 1). This survey was distributed to patients A Comprehensive Approach to Improving Cancer Pain Management and Patient Satisfaction