Postoperative pain management in frail older adults.
OBJECTIVE
To evaluate the Frail Elder Pain Management Program (FEPMP) implemented for patients who had hip fracture repairs at a community hospital in 1995. Based on standards of geriatric and pain management practice, the FEPMP included education sessions, preprinted analgesic orders, pain flow sheets, written resources, and clinical support. A Logic Model reflected the program's conceptualization.


METHODS
Preexperimental pretest and posttest design.


METHODS
A random sample of 50 charts of patients aged 75 and older who had hip fracture repairs were audited from each of two periods: the preimplementation period (1994-95) and the postimplementation period (1997-98).


METHODS
A chart audit tool was developed, tested, and used. Data were analyzed using descriptive, parametric and nonparametric statistics.


RESULTS
Surgeons' prescriptions and nurses' pain management practices improved significantly (p = .0001). Pain assessment modestly improved. Patient outcomes also improved. IMPLICATIONS FOR PRACTICE AND EDUCATION: A programmatic approach to pain management is effective for improving practice and outcomes for frail elders.
MacDonald
V
V
Vancouver Hospital and Health Sciences Centre.
Hilton
B A
BA
D000368:Aged; D000369:Aged, 80 and over; D004358:Drug Therapy / Q000451:nursing / Q000706:statistics & numerical data; D016330:Frail Elderly; D006302:Health Services Research; D006801:Humans; D016530:Orthopedic Nursing; D010149:Postoperative Pain / Q000628:therapy*; D010346:Patient Care Management / Q000458:organization & administration*