Date of Award

4-21-2017

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Jeffrey Coto

Abstract

Pain is one of the most common experienced symptoms reported by more than 80% of postoperative patients. Approximately 77-98% of postoperative patients report pain following their procedure with 40- 80% having moderate to severe pain. Pain is shown to elevate stress levels manifesting in increased heart rates, blood pressures, and oxygen demand. Inadequate pain control can develop into surgical complications causing surgical failure, blood clots, pneumonia, and chronic pain. Complimentary and alternative medicine such as music can be used in combination with opioid medication help improve pain control leading to successful surgical outcomes. The purpose of this evidence-based practice project was to determine if implementing therapeutic music into the post-operative recovery process improves reported pain scores and decreases pain medication usage in milligrams in adult spinal patients. The evidence-based medicine (EBM) model was used to guide this evidence-based project. The project was implemented in a small Northwest Indiana facility. An extensive review of the literature was completed directing the creation of a therapeutic music protocol. The organization formally approved the protocol and education was provided to the inpatient nursing staff. A one-group pretest-posttest comparison design was conducted to streamline the protocol. Implementation occurred on postoperative days 3 and 4 for each participant and data was collected during weekly chart audits. The mean day 3 pain scores were (M = 5.769, SD = 1.945; M = 5.692, SD = 1.954; M = 5.692, SD = 2.112) compared with day 4 scores with corresponding time (M = 5.115, SD = 2.268, p = .000; M = 4.846, SD = 2.110, p = .000; M = 4.846, SD = 2.344, p < .004). Medication amounts were compared in the same manner resulting in day 3 (M = 37.673, SD = 45.008; M = 35.682, SD = 33.506; M = 35.798, SD = 37.313) and day 4 (M = 37.172, SD = 47.161, p = .000; M = 29.961, SD = 35.748, p < .019; M = 31.451, SD = 37.437, p = .000). The results demonstrate a significant difference in decreases in pain scores and milligrams of morphine when therapeutic music is used in combination with opioid pain medication.

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