Effectiveness of a strengthened standing-order nurse-initiated analgesia guideline on provision of analgesia in the emergency department.

An audit of analgesia provision in the ED undertaken in 2019 found that time to initial analgesia delivery and monitoring of effect did not meet national quality standards. In 2021 the local standing-order nurse-initiated analgesia (SONIA) guideline was re-written and introduced. This included a strengthening of the indications and increased enablers for nurses to deliver initial analgesia prior to medical assessment. Education accompanied guideline introduction. Stage 1: Literature search and summary on effectiveness of nurse-initiated analgesia programs in ED, including where available, recognized barriers and enablers to timely analgesic delivery. This will comprise the introduction of a pre and post-intervention study to determine the effect of the guideline introduction. Stage 1 will culminate in ethics submission. Stage 2: Conduct of the pre- and post-intervention retrospective CQI study, with data collection, analysis and preliminary report preparation. This will inform the likely need for Stage 3 and conclude the 2023 project (although stage 3 below may be possible). Stage 3: Design and conduct a survey to elicit barriers/enablers to timely analgesic delivery. This report would inform further process changes, possibly including changes to the SONIA guideline, other related practices (e.g. medication checking procedures) or the suggestion of additional measures.