Email To Angie Emily Max 6 4 14

7/21/2014 RE: Upcoming Pain Champions Meeting - Davis, Aurora
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RE: Upcoming Pain Champions Meeting
Hi, Angie.
Originally I designed the tool for my Level 3 project to attempt to improve my unit's HCAHP scores for
pain. I had it approved by leadership on my unit and then presented it to the Pain Committee for approval.
After they approved it--with some changes along the way--it was decided by the committee that this
should be a house wide initiative and should roll out everywhere. I also had it approved by the Acute Pain
Service and the Patient Education Committee. I then took it to the Nurse Educator Council, who agreed on
the house wide roll out, and decided it should be a level 2 roll out. I spearheaded the roll out on my own
unit, but my understanding was that education and implementation on other units was to be handled by
their educators with the Pain Committee members as back up.
We've been following up with Pain Committee members at the last two meetings to see if their units are
using the tool, and results seem sporadic. Max and I offered to help the Pain Champs wherever we can to
get the tools out and available. I know the PACU has had them laminated and placed at their bedsides and
that the outpatient clinics are planning to start using them, too.
Aurora
Aurora Davis, RN, BA, BSN, OCN
Relief Charge Nurse
Oncology and Bone Marrow Transplant Unit
University of Colorado Hospital
Aurora.Davis@uchealth.org
From: Hill, Angela
Sent: Wednesday, June 4, 2014 11:59 AM
To: Swedhin, Amanda M; Doyle, Emily F
Cc: Davis, Aurora
Subject: RE: Upcoming Pain Champions Meeting

Hi there!
Sorry for the delay in my response - I've been out on PTO. From what I understand from the last pain
meeting, some units are rolling out the orange education sheet and some are not. Aurora, would you
remind me of all the committees this form was presented to and approved by? I would appreciate this
information so I may relay this to the nurse managers tomorrow during our nurse manager council
meeting. From past experience, when a new form/process is rolled out, it is good to get buy-in from the
nurse managers and educators, otherwise, things get dropped/missed/etc. Nurse managers have to
Davis, Aurora
Wed 6/4/2014 2:38 PM
To:Hill, Angela <Angela.Hill@uchealth.org>; Swedhin, Amanda M <Amanda.Swedhin@uchealth.org>; Doyle, Emily F
<Emily.Doyle@uchealth.org>;
budget for new forms like this, and to have their approval is beneficial. I have asked my PSCs to order
these and we are now placing them in the Roadmap to Care folders.

Max, I agree with you about the white boards. There are some units and managers who may not want to
utilize the new laminated sheet for a variety of reasons. I will also advocate for this during tomorrow's
meeting and let you know the managers' feedback.

Thanks to all of you for taking pain so seriously! I am confident that we will move the dial in the right
direction!

Angela Hill, RN, BSN, CMSRN
Nurse Manager
Transplant and General Surgery
x80930 or pager 266-6444

From: Swedhin, Amanda M
Sent: Tuesday, May 27, 2014 12:28 PM
To: Doyle, Emily F
Cc: Davis, Aurora; Hill, Angela

Emily,
Thanks for the follow up e-mail!
Sorry to hear that you will be movingyou will be missed! As far as clearing the Nurse Manager council, Angie is
bringing this to them at their next meetingShelly can discuss her concerns with both adding the sheet to the
Roadmap to Care and the white board additions at this time. It was discussed at the previous 2 Pain Champions
meetings that the Patient Education sheet was approved for use by the Pain Champions to replace the previous
Pain Education sheet that should be used at admittance but has obviously fallen through the cracks J Adding it
to the Roadmap to Care was a suggestion for usage from the Pain Champions, however, if youre unit would like
to utilize it in a different manner, that is completely appropriate. Please let me know what you decide on as a
unit. For instance, the ICUs and PACU would like to have them laminated at the bedside for use on patients
when appropriate because most of their patients are unable to respond to them.
As far as the addition to the white boards, this was a tool utilized by the Surgery unit that helped them improve
their HCAPs scores from the 50s to the 90s. While the white boards may contain this information, it has come to
our attention that a removable (say by velcroing a laminated sheet to the board) form may be more appropriate
for most patients because you can bring it to the bedside and allow the patient to fill in times while discussing it
with you, or it allows the patient to actually see what has been written on the board. I will be auditing units
randomly throughout the next 4 months to check on usage of the white boards for discussion of pain plans with
patientsif I see that units are utilizing the spots that are already designated for this/other spots are being used
to discuss pain, then I agree with Shelly to not add another piece to your boards. However, if it is not being
done, something needs to occur to ensure that they are being used. If Shelly would like to use the white boards
as they currently sit, that is fine, but please send me an e-mail detailing out how your unit plans on using the
Pain Education sheets and discussing pain plans via white board so that I can keep track of your units specific
plan.
I hope to see someone from your unit at future meetings to discuss this further! If Shelly has any more
questions regarding what we are doing, please feel free to have her contact myself, Aurora Davis (my co-chair),
or Angie Hill (our nurse manager rep). Also, if you need copies of the materials Ive distributed previously,
please let me know!

Amanda Max Swedhin, RN, BSN, CMSRN
Medical/Surgical PCU Educator, Pain Champions Co-Chair
Amanda.Swedhin@uchealth.org
Office: 720-848-7720
Pager: 303-266-0461
Cell: 720-339-6819

The Department of Professional Resources improves lives by empowering healthcare professionals to influence
quality care through education, discovery and navigation of change.

From: Doyle, Emily F
Sent: Monday, May 26, 2014 3:58 AM
To: Swedhin, Amanda M

Hi Max--

I had planned on attending the meeting mid shift on Wednesday but things went haywire as they do on
occasion. I did talk with Shelly a couple of weeks ago about the two additions. She liked the idea of the
addition to the Roadmap to Care but said it would need to pass nursing council, which I think Angie was
doing. Has it officially cleared the council do you know?
The white board addition we thought might be too much with out a ton of extra benefit-- Shelly was afraid
it would just add more busy-ness. We do try and include that information in the board space we have on
our new white boards.

So sorry I missed the meeting! I will actually be moving in October and was going to meet with Shelly to
see if she wanted me to train someone else on pain, to help Margo when I leave.

Have a good holiday!
Emily
From: Swedhin, Amanda M
Sent: Saturday, May 17, 2014 6:19 AM
To: Samz, Nathaniel; Fisher, Brett; Anderson, Ashleigh R; Banh, Micheal H; Bartel, Andrea M; Behrens, Melissa;
Bishop, Miranda R; Brelsford, Jennifer C; Bruce, Katherine C; Buese, Dori; Campbell, Jennifer L; Cole, Danielle;
Cottrell, Tynia; Cyriacks, Wendy; Danziger, Iris; Davis, Aurora; Deavers, Jacqueline; Dingmann, Colleen; Donovan,
Katherine J; Doyle, Emily F; Fink, Regina; Gill, Rodney; Hill, Angela; Hochhalter, Liana; Hornick, Lynn; Juelich,
Katherine; Kidd, Kenneth O; Kirchner, Nicole; Koziel, Virginia; Kral, MaryBelle; Krumbach, Barbara; Lambert,
Emily R; Lenny, Nicole; Luebbe, Lauren M; Lyda, Clark; Metz, Nora; Moberg, Rhonda R; Montgomery, Robert;
Neale, Nicole D; Page, Beverly; Paulsen, Kyle S; Petrie, Janna; Rich, Ann M; Rwubusisi, Rebecca A; Serlin, Margo;
Swedhin, Amanda M; Tuason, Chuchay; Williams, Kirsten
Subject: Upcoming Pain Champions Meeting

Hello Pain Champions!
Our monthly meeting is next Wednesday, May 21st from 1200-1300 in AOP 2005. I've attached the agenda (in the
new format!).

Please come prepared to discuss how things are going on your units--are you using the Pain Education sheets?
Have you heard any feedback on them? Also, have you discussed using the White Board addition on your units
with your manager yet? Are you having any push-back or difficulty starting this process? Let's come up with
some ways to help everyone out! If you haven't sent feedback to Katherine Bruce regarding the attached White
Board suggestions, please do so!

Remember, these initiatives, while being discussed with Educators, are ultimately YOUR RESPONSIBILITY on
your unit! We want this to be a house-wide initiative and we need everyone participating in order to change
our culture.
I've also included the e-mail I sent out after our last meeting in case you need to see it again. The DOD # is
included (highlighted!) for your managers to order copies for your Roadmap to Care folders if they have not
already.

Thank you for all you do! See you next week!

Amanda "Max" Swedhin, RN, BSN, CMSRN
Medical Surgical PCU Educator, Pain Champions Co-Chair
amanda.swedhin@uchealth.org
office: 720-848-7720
cell: 720-339-6819
pager: 303-266-0461

PREVIOUS E-MAIL OUTLINING OUR PLAN FOR IMPROVING HCAPS SCORES----

As promised, I am sending out the suggestions we came up with from our April meeting to start working on
improving our HCAPS scores. To review:

-Aurora has produced a patient Pain Education sheet that needs to be included in the Roadmap to Care
admission packet for every patient. Please discuss these with your unit manager for them to order through
Documents on Demandthe copy I have attached is only a draft. The DOD # to order them is PED05219. They
need to be printed on bright orange paper. I have discussed use of these with an Educator from the Outpatient
clinics (Maude Becker) and we should see this trickling into their Charge nurse and managers meetings in the
next month to talk about how they want to utilize this prior to coming in for procedures. Barb had mentioned
placing these in a patients chart in the PACU, however, it has been decided that the PACU will laminate these
sheets and place them at the patients bedside for use in their departmentit will be each departments job to
make sure that they get it into their Roadmap to Care starting as soon as your manager gets the sheets.

-Aurora came up with the following scripting ideas to help nurses know the right way to start discussions about
the Pain Education sheet:
1. I want to work with you to develop a plan to manage your pain.
2. Is your pain always well controlled?
3. Am I doing everything I can to help with your pain?
These would be great questions to use when talking to staff about pain assessment using the sheet. What do we
think of these? Want to make sure were all using the same verbiage when talking to our staff so that the
message is consistent house-wide.

-I have attached the suggestions for the addition to our current white boards to help aide discussions about pain
management. As Angie talked about at our last meeting, the Surgical unit was having difficult time with pain
satisfaction scores and enacted the use of a white board with similar wording/structure and increased their
satisfaction scores by approximately 40% (please correct me if Im completely wrong on those numbers, Angie).
Our proposal that we need each of you to come to your manager with is to add a laminated copy of the attached
form to your patients white boards in the room (attaching it however you see fitmy suggestion is Velcro, but
something else might work for your unit) that you could use to write down your patients comfort function
goals, the timing of their medications and alternative therapies that you discuss/the patient would like to use.
BEFORE WE START USING THIS, PLEASE TAKE IT TO YOUR MANAGERS AND SEND ANY FEEDBACK TO Katherine
Bruce AT Katherine.bruce@uchealth.org. I will send out a reminder e-mail in one week from today to give us
the go-ahead to start using this on the units.

If your managers have questions as to why these are the areas we are focusing on, we are basing this off of the
house-wide inpatient surveys Regina Fink has been leading over the past year to gain more information on our
patients perspective of pain management while they are hospitalized. The data showed that a majority of
patients are unaware of alternative therapies or that we are using them to help with pain and that they feel
communication and education are lacking regarding their pain management and side effects of pain
medications. We are hoping that the patient Pain Education sheet as well as the new white board format will
help nurses begin that communication with patients.

While I am planning on sending out an e-mail to the mangers/educators for the hospital, we want this to be
driven by YOU!!! I expect that when I send out an e-mail detailing what we have discussed through the Pain
Champions that they will have already heard about it. Please get out there and discuss with your managers and
let us know areas you need assistance with. Thank you for all the work you do!

P.S.for those of you unable to attend the last monthly meeting, we are no longer requiring monthly pain re-
assessment audits. These only need to be done quarterly. Aprils audits need to go to Janna Petrie, but after this
month, it will be the Pain Champions job to compile quarterly audits only.

office: 720-848-7720
cell: 720-339-6819
pager: 303-266-0461
office: 720-848-7720
cell: 720-339-6819
pager: 303-266-0461

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