title: [Monitoring of patient-controlled analgesia by the nursing staff].
abstract: OBJECTIVE
  Patient-controlled analgesia (PCA) is employed successfully on surgical wards. Continuous monitoring is important for the safety of the patient and the efficiency of this form of pain therapy. In the study we evaluated the regularity and completeness of monitoring data which had been collected by the nursing staff on the surgical wards.
  
  
  METHODS
  Data on pain intensity, vital signs, and side effects were collected. Additionally, in the case of epidural analgesia, sensory and motor function were tested. In the first four hours after starting the PCA-pump, the nursing staff was instructed to document this data hourly (phase I), followed by a two hour interval until 8 am the next day (phase II). In general, monitoring was continued every four hours up to the discontinuation of the PCA; whereas in our study only forty hours (10 measurements) were included (phase III). Documentation protocols of 637 patients were evaluated and tested for the completeness of the data.
  
  
  RESULTS
  In phase I, the data of 128 patients (20%) were complete. In 173 patients (27%) less than 50% of the data were documented. During phase II, only in 98 patients (15%) the data collection was complete. In 237 patients (37%) less than 50% of the measurements were determined. In phase III, in 205 patients (32%) all measurements, and in 104 patients (16%) less than 50% of the measurements were documented.
  
  
  CONCLUSIONS
  Complications during PCA become manifest mainly during the first hours after starting the PCA-pump. Especially during these phases, documentation was found to be quite poor. This underlines the importance of an intense cooperation between acute-pain service and nursing staff with periodical training of the staff.
authors.affiliation: Klinik für Anästhesiologie, Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen. sambu@kfa.uni-erlangen.de
authors.forename: C
authors.initials: C
authors.lastname: Geiss
authors.forename: D
authors.initials: D
authors.lastname: Märkert
authors.forename: W
authors.initials: W
authors.lastname: Koppert
authors.forename: N
authors.initials: N
authors.lastname: Griessinger
authors.forename: R
authors.initials: R
authors.lastname: Sittl
mesh_terms: D016058:Analgesia, Patient-Controlled / Q000009:adverse effects / Q000451:nursing*; D004282:Documentation; D006801:Humans; D008991:Monitoring, Physiologic; D009741:Nursing Staff, Hospital; D010147:Pain Measurement; D013997:Time Factors