PDSA Cycles with P: Charts

PDSA Cycle #1 Weeks 1-5 (Mean morning pain assessment documentation 26%) (Figure 1)

The first intervention focused on consciousness-raising and information dissemination. During the brief meeting, the project leader presented the importance of pain assessment and the institutional and governance policies regarding routine pain assessment documentation. The KARSP survey correct answers were also discussed.

P: Chart 2 for PDSA Cycle #2

PDSA Cycle #2 Weeks 6-10 (Mean morning pain assessment documentation 44%) (Figure 2)

The second PDSA cycle focused on navigating the new EMR system. The clinical nurse specialist demonstrated how and where to document the morning pain assessment in the EMR. The demonstration was based on qualitative data obtained from unit nurses stating their difficulty with streamlining documentation with a complicated, recently installed EMR

P: Chart 3 for PDSA Cycle #3

PDSA Cycle #3 Weeks 11-16 (Mean morning pain assessment documentation 54%) (Figure 3)

The third PDSA cycle focused on the need for clinical decisions supports during the nursing workflow with the new EMR system. Nurses voiced their frustrations with minimal pain assessment reminders. Nurses explained their concerns over the lack of “hard stops” to ensure documentation was completed before moving to different EMR tasks. Therefore, non-EMR interventions included reminders in morning huddles, and laminated cards placed on all unit computers to remind nurses to document the morning routine pain assessment.