Abstract
Background
Aim
This pilot study assessed the feasibility and impact of integrating a Life Care Specialist
(LCS) into orthopaedic trauma care.
Design
This was a prospective feasibility single group pilot study at a level 1 trauma center.
Method
The LCS is a paraprofessional behavior-based “pain coach” and delivered patient-centered
opioid safety education, trained participants on nonpharmacologic pain management
approaches, conducted opioid risk assessments, and coordinated care. Numeric Rating
Scale pain scores were assessed on admission, at discharge, and at 2-week follow-up.
Daily morphine milligram equivalents (MME) during hospitalization, opioid medication
use at 2-weeks, and patient satisfaction were recorded. T test compared mean morphine milligram equivalents (MME) to historical orthopaedic
trauma patient population's mean dosage at discharge from the study site. Generalized
linear models assessed pain scores over time.
Results
Twenty-two percent of 121 total participants met criteria for moderate to severe risk
of opioid misuse at initial hospitalization. On average, 2.8 LCS pain management interventions
were utilized, most frequently progressive muscle relaxation (80%) and sound therapy
(48%). Mean inpatient MME/day was 40.5, which was significantly lower than mean historical
MME/day of 49.7 (p < .001). Pain scores improved over time from admission to 2-weeks postoperatively
(p < .001). Nearly all participants agreed that the LCS was helpful in managing pain
(99%).
Conclusions
The findings indicate feasibility to integrate LCS into orthopaedic trauma care, evident
by participant engagement and satisfaction, and that LCS serve as valuable resources
to assist with pain management and opioid education.
Keywords
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Article info
Publication history
Published online: April 24, 2022
Accepted:
March 23,
2022
Received in revised form:
March 8,
2022
Received:
October 25,
2021
Identification
Copyright
© 2022 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
