Pain free hospital: organisation aspects.
The rational approach to acute pain management is to use the highest quality evidence available. Acute pain management is more than a collection of interventions. It is a package of care that needs to be examined as a whole as well as in its parts. In the context of acute pain management, this comes from systematic reviews of valid randomised trials. We still have to adapt to the circumstances of the individual, but our policies will be more discerning. Acute pain is not confined to postoperative wards but it is a problem in many clinical settings. Educational programs for allied health professionals are equally important because they play the key role in the management of acute pain. Accreditation and educational programs in individual institutions would enable the nurses to identify their learning needs, to acquire appropriate knowledge and skills to ensure that they are adequately prepared for the responsibilities involved in pain management. The key of successful pain management is education, not new drugs or high-tech delivery systems. Existing tools can do the job if doctors and nurses are educated, both to dispel the myths and misconceptions and to take responsibility for providing pain control. It is much easier to dispel myths when you have the evidence. In 1846, the first anaesthetic provided pain-free surgery - 150 years later patients should not have to endure unrelieved pain anywhere in the hospital.
Bertini
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UOC Anestesia e Rianimazione, CTO, ASL Roma C, Rome, Italy.
D019317:Evidence-Based Medicine; D006757:Hospital Units / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D008505:Medical Staff, Hospital / Q000193:education; D009741:Nursing Staff, Hospital / Q000193:education; D018710:Pain Clinics / Q000458:organization & administration / Q000592:standards*; D059408:Pain Management