Implementation of evidence-based practice for a pediatric pain assessment instrument.

Purpose/objectives: The purpose of this project was to facilitate the successful implementation of an evidence-based practice (EBP) change to the Faces Pain Scale-Revised (FPS-R) using the Promoting Action on Research Implementation in Health Services (PARIHS) framework.

Background/rationale: Accurate pain assessment is a high priority in the clinical setting. Despite the availability of valid pain assessment instruments, use in practice remains deficient. Compared with the Wong-Baker FACES Pain Scale, the FPS-R has stronger evidence for validity and reliability and is identified as a preferred instrument to measure children's pain. The PARIHS framework, developed to guide the change process of EBP implementation through strong evidence, quality of context, and type of facilitation, was used in the development and implementation of the project.

Description: The clinical nurse specialist implemented an education program about EBP and FPS-R for nurses, followed by a 2-week pilot using FPS-R to assess children's pain. We measured perceptions of strength of evidence, quality of context, and barriers to research utilization.

Outcome: Nurses reported positive perceptions about the strength of evidence for FPS-R and identified unit context as moderately receptive to change before the project. Nurses' perceived barriers to research utilization did not significantly change after the project.

Conclusion: Nurses' positive perceptions about the use of FPS-R were based on strong evidence, quality context, and type of facilitation. The PARIHS framework supported this successful EBP change. The PARIHS framework can be applied by the clinical nurse specialist in the clinical setting, with minimal effort, to facilitate EBP implementation.