Professional Documents
Culture Documents
Clinical Question & Search Strategy
Clinical Question & Search Strategy
al., 2011). This is an unacceptable length of time to leave someone to suffer. A national standard
of time to first analgesia has been identified as 30 minutes (Doherty, Knott, Bennetts, Jazayeri,
& Huckson, 2013). There have been attempts to bridge the gap in providing timely and effective
pain management in the Emergency Department. Nurse Initiated Analgesia (NIA) is one modality
that has been recommended internationally. NIA is the provision of analgesics by a non-
prescribing nurse following a set protocol for administration by means of hospital approval or
standing orders (Cabilan & Boyde, 2017; Hatherley et al., 2016). ED nurses are in prime place to
pioneer such interventions as they are on the front-line of healthcare provision where patients
seek help (Fry et al., 2011). Concerns are often raised on the potential of adverse events
occurring from such interventions but research has shown there is low-risk of adverse events
occurring once a strict protocol is in place (Cabilan & Boyde, 2017). Further study is however
The setting for which this review is being performed is a tertiary paediatric trauma centre in
Melbourne that sees up to 90,000 patients per annum. Nursing staff can initiate some
medications as per protocol which include, first dose salbutamol, topical anaesthetics and
medical prescription is required. This often leads to reduced provision of sufficient analgesia or
nurse initiated analgesia protocol would significantly increase the provision of analgesia to
For the purposes of this paper, a PICO format will be utilised to develop the clinical question to
guide the literature review. The clinical question for this review is: