title: Pharmacy-initiated introduction of patient-controlled analgesia to a 400-bed community hospital.
abstract: The pharmacist's role in the implementation of patient-controlled analgesia (PCA) in a 400-bed community hospital is described. PCA for postoperative patients was introduced on the recommendation of the pharmacy and therapeutics committee. A subcommittee selected a PCA pump, developed a physician order form and patient monitoring sheet, and in March 1987 initiated a two-month pilot study of PCA therapy in orthopedic-surgery patients. An orthopedic-service pharmacist developed an inservice-education program for the physicians, anesthesiologists, and nurses involved in the care of these patients. Because of the support of anesthesiologists for this program, PCA use during the two-month period rapidly expanded beyond orthopedics to include general and genitourinary-gynecologic patients. Nursing staff demand for PCA inservice education became so great that all staff pharmacists participated in the teaching. Pharmacists in the decentralized areas also provided one-on-one instruction to physicians, nurses, and patients. Positive evaluations of PCA therapy by patients and nurses and favorable patient pain assessment scores, in addition to the hospital-wide acceptance and use of PCA by medical staff, indicated that the program was a success. Active pharmacist participation was a major factor in PCA being well accepted by physicians, nurses, and patients as an effective alternative method of narcotic administration.
authors.affiliation: Department of Pharmacy, Lutheran Medical Center, Wheat Ridge, CO 80033.
authors.forename: T R
authors.initials: TR
authors.lastname: McKenna
authors.forename: T A
authors.initials: TA
authors.lastname: Branigan
authors.forename: A H
authors.initials: AH
authors.lastname: Sorocki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage*; D003120:Colorado; D005260:Female; D006745:Hospital Bed Capacity, 300 to 499; D006764:Hospitals, Community / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010146:Pain / Q000188:drug therapy; D010358:Patient Participation; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D010606:Pharmacy and Therapeutics Committee
chemical_list: D000700:Analgesics