NURS FPX 8004 Assessment 2 - Capella DNP.pdf

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1. NURS FPX 8004 Assessment 2: Professional Practice Plan
Student Name
Capella University
NURS-FPX8004
Professor Name
Submission Date







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2. Professional Practice Plan
Pain management is a cornerstone of quality care in inpatient rehabilitation facilities (IRFs).
Successful rehabilitation depends not only on structured therapy sessions but also on ensuring
that discomfort does not prevent patients from fully participating. Evidence shows that older
adults—particularly those over the age of 65—often experience delays in accessing timely,
conservative pain control methods, which slows recovery and reduces quality of life (Minteer et
al., 2025). Despite clinical recommendations that emphasize nonpharmacologic and nonopioid
interventions as first-line approaches (Lange et al., 2022), practice across facilities remains
inconsistent. This lack of uniformity results in unnecessary patient suffering and longer
rehabilitation stays. A system-wide adoption of standardized policies, in line with the CDC’s
2022 pain management guidelines, can help ensure equitable, evidence-based treatment
beginning at admission.
Population
IRFs primarily care for adults who require intensive therapy following serious health conditions
such as stroke, orthopedic surgery, cardiac events, or other debilitating illnesses (AHA, 2025).
The majority of these patients are older adults managing multiple chronic conditions that
complicate both medical stability and therapy participation. Rehabilitation programs typically
require at least three hours of therapy daily, which can be difficult to complete without effective
pain relief (AOTA, 2021).
The practice plan applies to adults aged 18 years and older who are admitted to IRFs and require
pain management. Excluded from participation are patients with severe cognitive impairment
(MMSE < 15), individuals with contraindications to nonpharmacologic interventions, and those
expected to remain in the facility for fewer than 48 hours (Rice et al., 2023). While surgical
patients are generally admitted with established pain control regimens, nonsurgical patients often
lack comparable management plans. This gap in standardized protocols frequently results in
inadequate pain relief, reduced participation in therapy, and extended lengths of stay (Minteer et
al., 2025).
Stakeholders
The success of this professional practice plan requires the coordinated involvement of multiple
stakeholders:
• Patients and Families: They are the primary recipients of care and bear the
consequences of poorly controlled pain. Education will focus on encouraging timely pain
reporting and engaging families in supporting nonpharmacologic strategies.
• Nursing, Medical, and Therapy Staff: These professionals deliver daily interventions
and play a critical role in balancing pharmacologic and conservative treatments.
Continuous training will be provided to strengthen consistency and adherence to
evidence-based practices (Charumbira et al., 2024).

3. • Administrative and Leadership Teams: Leaders establish policies, allocate resources,
and measure performance outcomes. Their endorsement is vital for embedding pain
management strategies into organizational culture and sustaining long-term success
(Teame et al., 2022).
Stakeholder engagement will be reinforced through targeted strategies: patient education
sessions, clinician workshops on efficient pain response, and leadership presentations using IRF
performance data to demonstrate the link between pain management and improved functional
outcomes (Caneiro et al., 2021). To foster collaboration, an interdisciplinary pain management
committee will be formed, ensuring ongoing evaluation and shared responsibility for outcomes
(Hansen et al., 2025).
Problem Question
PICOT Question:
In adult patients receiving care in inpatient rehabilitation facilities (P), how does adopting an opt-
out model for conservative pain management interventions (I), compared to current policies
requiring physician authorization (C), influence the timeliness of pain relief responses (O) over a
12-week period (T)?
• Population (P): Adult patients in IRFs requiring pain relief
• Intervention (I): Opt-out policy allowing automatic use of conservative interventions
• Comparison (C): Standard practice requiring physician approval
• Outcome (O): Faster implementation of pain relief measures
• Time (T): 12 weeks
Conclusion
Uncontrolled pain remains a significant barrier to rehabilitation, limiting patient engagement in
therapy and delaying functional progress. Although national guidelines recommend early and
consistent use of nonpharmacologic and nonopioid pain strategies, practice variations leave
many patients inadequately treated. Implementing an opt-out model would empower nursing
personnel, eliminate delays in initiating conservative measures, and improve both patient
satisfaction and rehabilitation outcomes. The success of this initiative will depend on
interdisciplinary cooperation, leadership support, and commitment to evidence-based standards.
By embedding these practices into institutional policy, IRFs can better align care with patient-
centered values while enhancing recovery efficiency.
References
American Hospital Association. (2025, July 17). Post-acute care case study.
https://www.aha.org/case-studies/-encompass-health-us

4. American Occupational Therapy Association. (2021, April). Therapy outcomes in post-acute
care settings (TOPS) study chartbook. https://www.aota.org/-
/media/corporate/files/advocacy/federal/tops/tops-study-chartbook.pdf
Caneiro, J. P., Bunzli, S., & O’Sullivan, P. (2021). Beliefs about the body and pain: The critical
role in musculoskeletal pain management. Brazilian Journal of Physical Therapy, 25(1), 17–29.
https://doi.org/10.1016/j.bjpt.2020.06.003
Centers for Disease Control and Prevention. (2024). Nonopioid therapies for pain management.
https://www.cdc.gov/overdose-prevention/hcp/clinical-care/nonopioid-therapies-for-pain-
management.html
Centers for Medicare & Medicaid Services. (2025, June 27). Inpatient rehabilitation facility
(IRF) quality reporting program (QRP) measures information.
https://www.cms.gov/medicare/quality/inpatient-rehabilitation-facility/irf-quality-reporting-
measures-information
Charumbira, M. Y., Kaseke, F., Conradie, T., Berner, K., & Louw, Q. A. (2024). A qualitative
study on rehabilitation services at primary health care: Insights from stakeholders in low-
resource contexts. BMC Health Services Research, 24(1), 1272. https://doi.org/10.1186/s12913-
024-11748-9
Hansen, K. A., Blakeney, E. A. R., & Price, C. J. (2025). Implementation outcomes from a pilot
study of mindful awareness in body-oriented therapy (MABT) as a chronic pain treatment
modality. Global Advances in Integrative Medicine and Health, 14(1), 319244.
https://doi.org/10.1177/27536130251319244
Lange, S., Dąbrowska, W. M., Friganovic, A., Oomen, B., & Krupa, S. (2022). Non-
pharmacological nursing interventions to prevent delirium in ICU patients: An umbrella review.
Journal of Personalized Medicine, 12(5), 760. https://doi.org/10.3390/jpm12050760
Minteer, S. A., Tofthagen, C., Sheffield, K., Cutshall, S., Launder, S., Hein, J., McGough, M.,
Audeh, C. M., Tilburt, J. C., & Cheville, A. L. (2025). Delivering an EHR-based intervention
promoting peri-operative non-pharmacological pain care: Nurses’ perspectives. JMIR Nursing, 8,
70332. https://doi.org/10.2196/70332
Rice, R., Bryant, J., & Fisher, R. S. (2023). Documentation of cognitive impairment screening
among older hospitalized Australians: A prospective clinical record audit. BMC Geriatrics,
23(1), 672. https://doi.org/10.1186/s12877-023-04394-z
Teame, K., Debie, A., & Tullu, M. (2022). Healthcare leadership effectiveness among public
health managers in Addis Ababa: A mixed methods study. BMC Health Services Research,
22(1), 540. https://doi.org/10.1186/s12913-022-07540-0

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