Registed Nurses' Association of Ontario

Supporting Best Practice for Patient Care: A Mulitple Branch Implementation of the RNAO Assessment and Management of Pain Best Practice Guideline

Flora Turner
Hamilton Niagara Haldimand Brant Community CareAccess Centre

The RNAO Advanced Clinical Practice Fellowship has provided a learning experience that has been enlightening and motivating both personally and professionally. My goal was to improve knowledge and skills to expand a model for implementing RNAO Best Practice Guideline for the Assessment and Management of Pain with consideration to harmonization of practices for Service Providers and Care Coordinators. Four key components to the learning plan involved creating knowledge and understanding of Chronic Non-Cancer Pain, principles of adult learning, effective guideline implementation and mechanisms for successful sustainability.

Cultivating knowledge creation through literary review, shadowing peers and attending topic related workshops resulted in the development of learning material to support change to nursing practice and improve patient outcomes. Fellow disseminated knowledge across 5 branches ( 24 sessions) in 2 segments. The first, introduced the physiology and psychology of pain, recommendations for the screening and assessment of pain and review of pain management strategies. The second, involved taking that knowledge and applying it to practice supported by a decision tree and service order guidelines with view to comprehensive pain assessment and client-centered service planning. I enjoyed the opportunity to collaborate with Service Providers with the goal of harmonizing the same assessment and management recommendations as taught to Care Coordinators. They too were provided presentations identifying screening and assessment recommendations and their clinical role. Service Provider Reports were adjusted to support documentation of the new pain assessment.

Throughout the implementation process collaboration also occurred with Management, Senior Management, Director of Professional Practice, Communications, Continuous Improvement, Service Provider Relations (SQPM), Patient Experience and Collaboration Practice, Organizational Development
and a Physician Lead. All provided support to various strategies that were required to promote successful evidence-based practice change and sustainability.

Guideline implementation was not a new experience for this Champion of several wound pathways. It was however new to take the leading role. Sustainability planning was one of the more challenging experiences and certainly a common theme from those attending the RNAO workshops. The work culture strongly supports the use of evidence-based practice but until now has not always been successful at maintaining it. My goal is to continue to advocate for a standardized system that will not
only support this guideline implementation but all other implementations in the future. There are many new changes on the horizon which presents a great opportunity to have those discussions.

I would like to thank RNAO and the ACPF program for allowing me this tremendous opportunity. I will definitely encourage others to become more involved in the advancement of nursing practice and highly recommend the experience of participating in a fellowship. I would like to thank my mentors for their support and encouragement as well as those throughout the organization who were involved in my learning experience. The amount of support from all involved has been overwhelming.

Learn more about Advanced Clinical/Practice Fellowships now.