The issue
Each year, there are over 7 million reported presentations to emergency departments across Australia. For the majority of patients presenting to emergency departments, pain is a major concern and a cause of significant distress.
In 2007 a national audit was undertaken to establish current pain management practice in the emergency care setting. This audit identified the need for significant practice improvement.
The National Emergency Care Pain Management Initiative
In June 2008, NHMRC NICS Emergency Care Community of Practice launched the National Emergency Care Pain Management Initiative to implement the NHMRC approved guidelines for acute pain management in Australian emergency departments.
Significant improvements were achieved in all clinical indicators for this initiative including pain assessment, time to analgesia, and improvements in patient pain levels. Improvements were measured by auditing over 16,500 patient records from the emergency departments involved in this initiative between 2008 and 2010.
Key improvements during the Pain Management Initiative include:
- Early assessment of pain - 23% improvement in the documentation of patients initial pain score
- Reduction in median time to analgesia - A drop of 20 minutes in time to analgesia where a drop of 5 minutes is considered clinically significant for patients.
As a part of this project, the NHMRC Acute Pain Management Manual has been developed as a practical resource to support emergency clinicians by identifying evidence-based quality pain management options. The NHMRC is pleased to have worked with the Australasian College for Emergency Medicine, the College of Emergency Nursing Australasia and the Australian College of Emergency Nursing to develop and gain endorsement of this implementation resource.
This NHMRC project has proven to be a significant initiative which has been able to demonstrate national health care improvement in an important clinical issue.
National Emergency Care Pain Management Initiative resources
Pain Manual
The Pain Manual is a clinical tool to guide care for common painful presentations to the emergency department.
National Emergency Care Pain Management Initiative – Final Report
The final report summarises the development of this initiative including the intervention, its outcomes, and recommendations for implementation of best practice.
It is intended for clinicians, managers and agencies involved in the implementation of evidence-based guideline recommendations to improve care.
- National Emergency Care Pain Management Initiative – Final Report December 2011 (PDF, 833KB)
- Barriers and enablers to pain management in emergency department care: a literature review (PDF, 526KB)
For further information, please contact nics@nhmrc.gov.au.