Christina Hoddinott

Title : Comfort Cart: The use of non-pharmacological adjuncts for pain relief in an emergency department setting

Abstract:

The Comfort Cart is a pain management tool; it is a cart on wheels that is portable, can be easily brought to any patient area/room and contains non-pharmacologic pain relief adjuncts such as heating pads, ice packs, stress balls, eye pillows, ear plugs, as well as distraction tools such as magazines, reading materials, adult coloring books and guided imagery for pain relief. The patient may choose which adjunct to utilize and/or the nurse may  provide evidence-based practice suggestions on which adjust may provide the most pain relief for specific types of pain. The objective of this initiative was to improve pain relief in patients who report pain using nonpharmacological
adjuncts; sometimes in addition to pain medications appropriate to the patient complaint/diagnosis/presentation.
Methods:
After conducting evidence-based research on pain, the nurses deducted that if pharmacologic and non-pharmacologic methods are combined a more effective pain control may occur for the patient. With this knowledge the nurses developed and implemented a Comfort Cart. The Comfort Cart is a pain management tool that is portable; the cart contains nonpharmacologic pain relief adjuncts such as heating pads, ice packs, stress balls, eye pillows, ear plugs, as well as distraction tools such as magazines, reading materials, and adult coloring books. An iPad was purchased, and guided imagery was installed on it, allowing patients the ability to use guided imagery for pain relief. All staff were educated on the cart, its purpose, the contents, and the ways in which they may address and manage patients’ pain while in the emergency department. This education was done through mandatory staff education, emails, and flyers posted throughout the department.
Implications:
Based on the data and improvement scores, we have concluded that nonpharmacological methods enhance and improve pain management in patients who report pain in the emergency setting. The implication for emergency nursing is to adapt use of nonpharmacological adjuncts into practice. The recommendation is for management to ensure all nursing staff are educated on use of non-pharmacologic adjuncts and how non-pharmacologic adjuncts improve patient care. The implication for nursing is to understand the importance of non-pharmacologic adjunct use and how the affects of its adaption into practice can have many implications for the patient- from decrease in opioid use to increase in pain relief.

Biography:

Christina has been a nurse in emergency/trauma nursing since 2007. She received her Master of Science in Nursing degree as a Family Nurse Practitioner from Wilmington University in Wilmington, Delaware in 2018. She holds her certification as a Certified Emergency Nurse and as a Certified Pediatric Emergency Nurse. She developed and functioned as the Pediatric Nurse Coordinator for an emergency department for 6 years and was a part of the team that enabled the department to obtain State/National Recognition for Pediatric Care. She is a volunteer in the community and is a former member of the Delaware Emergency Medical Services for Children (EMSC) Committee through the State of Delaware Emergency Medical Services Office. In this capacity she was able to influence regulatory standards related to pediatric emergency care on a hospital, state-wide and national basis. Christina is an active ANCC Pathway to Excellence Appraiser which uses her expertise to assist hospitals on an international basis on their journey toward Pathway to Excellence. She is an adjunct clinical educator for the University of Delaware in Newark, Delaware. She has presented nationally at numerous conferences including Emergency Nurses Association Conference.