Background: Dyspnea (breathing discomfort) is a common and distressing symptom. Routine assessment and\ndocumentation can improve management and relieve suffering. A major barrier to routine dyspnea documentation\nis the concern that it will have a deleterious effect on nursing workflow and that it will not be readily accepted by\nnurses. Nurses at our institution recently began to assess and document dyspnea on all medical-surgical patients\nupon admission and once per shift throughout their hospitalization. A year after dyspnea measurement was\nimplemented we explored nursesââ?¬â?¢ approach to dyspnea assessment, their perception of patient response, and their\nperception of the utility and burden of dyspnea measurement.\nMethods: We obtained feedback from nurses using a three-part assessment of practice: 1) a series of recorded\nfocus group interviews with nurses, 2) a time-motion observation of nurses performing routine dyspnea and pain\nassessment, and 3) a randomized, anonymous on-line survey based, in part, on issues raised in focus groups.\nResults: Ninety-four percent of the nurses surveyed reported administering the dyspnea assessment is ââ?¬Å?easyââ?¬Â or\nââ?¬Å?very easyââ?¬Â. None of the nurses reported that assessing dyspnea negatively impacted workflow and many reported\nthat it positively improved their practice by increasing their awareness. Our time-motion data showed dyspnea\nassessment and documentation takes well less than a minute. Nurses endorsed the importance of routine\nmeasurement and agreed that most patients were able to provide a meaningful rating of their dyspnea. Nurses\nfound the patient report very useful, and used it in conjunction with observed signs to respond to changes in a\npatientââ?¬â?¢s condition.\nConclusions: In this study, we have demonstrated that routine dyspnea assessment and documentation was\nwidely accepted by the nurses at our institution. Our nurses fully incorporated routine dyspnea assessment and\ndocumentation into their practice and felt that it improved patient-centered care.
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