A comprehensive approach to pain management among adults with sickle cell disease in the emergency department

Sickle cell disease, “the most common blood disorder,” affects more than 100,000 people in the United States. Two million Americans are genetic carriers of the sickle-cell trait. The most common challenge sickle-cell patients face is pain management. As a result, they frequently utilize emergency services and hospitalization for pain management. Adult hospital visits are estimated at more than 230,000 per year, and readmission often occurs within a 30-day period. The prevalence and management of sickle-cell disease is examined in an acute care setting, as are care measures. Retrospective data was collected and analyzed regarding adult sickle-cell patient visits in the emergency department, to identify trends before and after implementation of a sickle-cell protocol pathway. Evidence-based guidelines were examined for acute care management. The objectives for this study are (a) to use a healthcare information database to extract data regarding utilization of services before and after implementation of the protocol, (b) find gaps in treatment from chart reviews, and (c) to create a white paper to recommend changes to provide better care. The theoretical framework used to formulate this project is the reach, effectiveness, adoption, implementation, and maintenance model. After the chart review, results showed that the adherence rates decreased overtime, admissions increased with the use of the protocol, first pain intervention time decreased, and reassessment times varied but did not align with facility policy.DNPIncludes bibliographical reference