Management of acute postoperative pain in Australian hospitals: Room for improvement

Taylor, Donna R., Loh, Shwu Fen, Mulligan, Kathleen T., Pulver, Lisa K., Tompson, Anna J. and Wai, Angela (2010) Management of acute postoperative pain in Australian hospitals: Room for improvement. Journal of the Australasian Association for Quality in Health Care, 20 2: 29-36.

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Name Description MIMEType Size Downloads
Author Taylor, Donna R.
Loh, Shwu Fen
Mulligan, Kathleen T.
Pulver, Lisa K.
Tompson, Anna J.
Wai, Angela
Title Management of acute postoperative pain in Australian hospitals: Room for improvement
Journal name Journal of the Australasian Association for Quality in Health Care
ISSN 1440-2599
Publication date 2010
Sub-type Article (original research)
Volume 20
Issue 2
Start page 29
End page 36
Total pages 8
Editor Robyn Quinn
Place of publication Gold Coast, QLD, Australia
Publisher Australasian Association for Quality in Health Care
Collection year 2011
Language eng
Formatted abstract
Objective:  To describe a quality improvement initiative in the management of acute postoperative pain in Australian hospitals.

Design:  Multicentre, cross-sectional, retrospective inpatient medical record review and post-discharge surveys of patients and their General Practitioners (GPs), conducted between October 2006 and October 2007, before and after targeted educational intervention.

Setting:  62 Australian hospitals - representing the spectrum of regional/remote to principal referral and including private and specialist hospitals.

Participants:  Up to 50 adults undergoing emergency/elective surgery per hospital, in each of baseline and follow-up phases.

Outcome measures:
  Documented preoperative education; pain and sedation assessment; safe and effective analgesic prescribing and communication of a pain management plan to patients/carers and their GPs at discharge.

Results: 
2704 baseline (2780 follow-up) patients were included. Documentation of preoperative education regarding postoperative pain was noted for 31% (44%) of patients. 57% (76%) of patients had at least one pain score documented in the postoperative data collection period. Of patients prescribed analgesia, 68% (74%) were prescribed regular paracetamol and 23% (18%) only as needed analgesia. Of patients prescribed opioids, 50% (61%) had at least one documented sedation score and 87% (90%) were prescribed an antiemetic agent. Discharge pain management plans were documented for 26% (40%) of patients and of these, 86% (87%) were communicated to patients and 71% (77%) to GPs.

Conclusions: Targeted interventions including one-on-one educational visiting and feedback of comparative data improved some key outcome measures; performance and documentation of preoperative education, post-operative pain and adverse event assessment and discharge communication with patients and GPs.
Keyword Postoperative pain
Quality improvement
Continuum of care
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Special issue: "Special 2010 Conference Edition".

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Pharmacy Publications
 
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Created: Mon, 24 Jan 2011, 15:03:45 EST by Lisa Pulver on behalf of School of Pharmacy