Iowa Model for Pain Management, Essay Example

Introduction

Delivering the best possible care and patient outcomes is the main aim of all health care organizations. Doody & Doody (2011) state that the introduction of the Iowa model of evidence based practice can create measurable improvements of care quality and patient outcomes alike. The below paper will examine the applicability of evidence based intervention in a nursing unit, where elderly patients are recovering from fractured hips. The author of the current study will examine how the IOWA model fits the nursing and care needs, current practices of elderly patients, and how it can improve their quality of life through pain management.

Evidence Based Pain Management Guidelines

The consensus document of recommendations regarding pain management in Britain (The British Pain Society, 2012) states that the first, and foremost important guideline to be taken into consideration when managing pain should be based on drugs that received marketing authorization. The document clearly highlights the importance of evidence based practice when prescribing off-label use or unlicensed medicine: “The prescriber must be fully informed about the actions and uses of the medicine, be assured of the quality of the particular product, and in the light of published evidence, balance both the potential good and the potential harm which might ensue” (The British Pain Society, 2012, p. 7).

Barr et al. (2013) created a revision of clinical intervention guidelines regarding the care of critically ill adults. The group of 20 researchers found that there is a need for introducing reliable pain measurement tools, such as the Behavioral Pain Scale and Critical-Care Pain Observation Tool (p.367). The authors further state that “The development of valid and reliable bedside assessment tools to measure pain, sedation, agitation, and delirium in ICU patients has allowed clinicians to man­age patients better and to evaluate outcomes associated with both nonpharmacologic and pharmacologic interventions” (p.266). This indicates that pain management practices benefit a great deal from evidence-based intervention.

Choi et al. (2013) examined the results of introducing evidence-based pain management among cancer patients. The authors highlighted the importance of reliable measurements and suitable intervention as follows: “measurements of pain do not necessarily translate to appropriate pain management. This discrepancy has significant effects on loss of function and quality of life” (Choi et al. 2013, p. 61)

The Benefits of the Iowa Model

The above review of pain management approaches in different health care unit settings has revealed that it is important to correctly evaluate and assess pain and develop evidence-based intervention strategies. The 7 step implementation model of Iowa (Doody & Doody, 2013) provides clear guidelines for health care unit leaders to create positive change for patients and practitioners alike. Unlike the model of implementation used by the research created by Choi et al. (2014), it includes quality assessment guidelines. Choi et al’s three step model consists of an initial baseline audit, a change implementation and feedback, and a follow-up audit. The Iowa model, however, provides a more detailed guideline that focuses on creating commitment among team members, and evidence based practice creation. In the current situation; developing an evidence based intervention strategy for pain management, it would be easy to follow the steps: selection of the topic: pain management, forming a team of nurses dealing with patients suffering from severe pain, retrieving evidence using pain assessment methods detailed above, grading evidence based on various pain management approaches used, developing an EBP Standard, implementing the EBP, and evaluating the results.

Conclusion

The above review of literature provided evidence that the Iowa EBP implementation model would be beneficial for pain management, as well as improving patients’ quality of life. Compared with other models, it is more detailed and is likely to provide better patient outcomes.

References

Barr, J., Fraser, G., Puntillo, K., Gelinas, C., Dasta, J., Davidson, J., Kress, J., Jotte, A., Coursin, D., Herr, D.,  Tung, A., Robinson, B., Fontaine, D., Ramsay, M., Riker, R., Sessler, C., Pun, B., Skrobik, Y. & Jaeschke, R. (2013) Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Critical Care Medicine. January 2013  Volume 41 Number 1

Choi, M., Kim, H., Chung, S., Ahn, M., Jae , J., Park, O., Woo, S., Kim, S., Kim, S., & Oh, E. (2013) Evidence-based practice for pain management for cancer patients in an acute care setting. 2013 Wiley Publishing Asia Pty Ltd

Doody, C. & Doody, O. (2013) Introducing evidence into nursing practice: using the IOWA model. British Journal of Nursing, 2011, Vol 20, No 11

The British Pain Society (2012) Use of medicines outside of their UK marketing authorisation in pain management and palliative medicine. The British Pain Society London.