Date of Submission

Summer 8-26-2018

Document Type


Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Alexa Curtis

Second Advisor

Jodi Sandhu


When a child is in pain, parents often seek out treatment at an emergency department. After a detailed chart review it was determined that only 32.53% of the pediatric patients who present to a rural, northern California, ED in pain receive any documented form of analgesia during their time in the ED. A review of the literature revealed that triage nurse-initiated protocols can successfully manage to provide consistent and efficient analgesia to patients who present to an ED with pain. Therefore, a practice improvement project was undertaken to increase of the consistency and efficiency of analgesia administration for pediatric patients who present to the ED in pain, through the implementation of a triage-based protocol. Outcomes of the improvement project included an increase in the percentage of pediatric patients presenting in pain who received documented analgesia from 32.52% to 62.2% and a reduction in the time of analgesia administration from 70 minutes to 59 minutes. The project concluded with highlighting the importance of rapport building with staff members in order to affect a successful engagement of the medical team in the improvement process and increased likelihood of sustainability.