October, 1999

The Benefit of a Computerized Documentation System to Examine Meperidine Usage and Evaluate Pain Management Practices

At Allina Health System – Mercy Hospital, Coon Rapids, MN, Susan Schmidt, RN, MS Pain Management Clinical Nurse Specialist, has taken advantage of computerized documentation to evaluate aspects of practice. Sue uncovered some interesting information on the use of meperidine that may help change physician practice patterns. She can query the system to find out how often meperidine is ordered and administered versus how often it is ordered and not administered. "We have standing pain medication orders for many of our post-operative patient populations. Nurses select from the list of choices, based on clinical assessment of the patient. I have found that meperidine is often ordered, but seldom selected as a choice by the nurses. When the nurses are asked why they do not select meperidine the answer they give is that they have found it does not work. Physicians may order meperidine, but may be surprised to learn how infrequently it is selected as a choice and that other options effectively manage the patient's pain." Sue is compiling the data now for presentation to medical staff involved in pain management.

Allina Health System – Mercy Hospital has also been able to implement changes to improve documentation. "We moved pain assessment to the top of our assessment form and found much better compliance as a result! We can also query the system to determine whether an assessment was documented within 8 hours of admission and whether an assessment of the patient's response to intervention is documented."

"What is exciting is the ability to query the system and quantify responses. The information provides great feedback to nurses and physicians. It reinforces that documentation has many positive aspects, including the ability to evaluate the effectiveness of interventions. There are any number of possible questions we can explore with the computerized documentation system. We can determine what pain medications are selected most frequently, correlate medications with patient response, and look for differences in various patient populations."

If you are a newer member of the PainLink community, you may wish to visit the "Members" section of the website to view the Action Plan Sue Schmidt and her team at Allina Health System developed awhile back. It is a great example of a plan that has been successfully implemented. To review this document go to the PainLink website (www.edc.org/PainLink) and click on the "members" section. Forgot your password? Email TmcIntire@edc.org for information. We cannot post it here, as this is a public document.

Last Updated: April 18, 2000