Table. Selected Domains and Findings from Pain Project Consolidated Framework
for Implementation Research Domain
Pain Project Findings
Characteristics of the Intervention
Nursing and Therapy Departments worked cooperatively to assess and treat resident pain, which was both a challenge and a facilitator to project success.
Increased amounts of documentation to better assess pain, plan for pain management, and communicate changes in resident pain.
Increased documentation perceived as burdensome by some Pain management training to nursing home staff was important.
Training medical providers as well would have been helpful.
Characteristics of Individuals
Supportive leadership is necessary to assist with budgeting, resource allocation, and act as a resource as problems arise.
Communication between nurses and nursing assistants was important to understanding the resident condition.
Nursing assistants expressed feeling empowered
Residents and families were both resistive and supportive of the Pain Project
The Inner Setting Factors that facilitated change: accessible leadership, staff enthusiasm, a supportive medical director, frequent
communication, a resident population with highly responsive acute pain, providing staff with praise for success
Factors that hindered change: cultural convention that medication is the best way to manage pain needs, resistance from providers, residents and families
The Outer Setting Resources from state-sponsored program were helpful and motivated success
Other facilities carrying out the same Pain Project provided project leaders with collegial support.
Measurement of pain was challenging and frustrating.
Processes of Implementation Engaging night shift in communication, especially with Therapists and medical providers, was a challenge.
Increased paperwork frustrated nursing staff.
Training staff early and encouraging nursing assistant participation facilitated implementation.
