Reducing time to analgesia in the emergency department using a nurse-initiated pain protocol: a before-and-after study.

Suboptimal management of pain in emergency departments (EDs) remains a problem, despite having been first described over two decades ago. A 'before-and-after' intervention study (with a historical control) was undertaken in one Western Australian tertiary hospital ED to test the effect of a 'nurse-initiated pain protocol' (NIPP) intervention. A total of 889 adult patients were included: 144 in the control group and 745 in the intervention group.