title: Patient-controlled analgesia: can client education improve outcomes?
abstract: This literature review considers research which would answer the questions: would preoperative information, by the nurse to the patient, about the use and purpose of a patient-controlled analgesia device (PCA) (a) reduce the amount of analgesic that the patient demanded from the device in the postoperative period; and (b) reduce the patient's overall experience of pain? The studies demonstrate wide variations in analgesic demand by patients using PCA, with high demand rates immediately postoperatively. In comparative PCA vs. intermittent intramuscular analgesic regimes, PCA users demonstrate higher overall drug usage. The hypothesis is not supported that, given free access to analgesic via a PCA, patients will administer sufficient analgesic to maintain a minimum effective analgesic concentration. Understanding how to use the PCA devices and what is expected of the patient is crucial to obtaining the optimum benefit from PCA. There is little mention of preparatory information given to patients in any of the studies. No studies addressed the question posted. There is a growing demand by patients for PCA. The question invites urgent investigation. The consequences for improving patient outcomes are considerable.
authors.affiliation: Mount Hospital, Perth, Western Australia.
authors.forename: P
authors.initials: P
authors.lastname: Shade
mesh_terms: D016058:Analgesia, Patient-Controlled / Q000451:nursing* / Q000523:psychology / Q000592:standards; D001291:Attitude of Health Personnel; D006801:Humans; D007389:Internal-External Control; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000523:psychology; D010353:Patient Education as Topic / Q000592:standards*; D016896:Treatment Outcome