Randomized clinical trial to assess the effect of an educational programme designed to improve nurses' assessment and recording of postoperative pain.
BACKGROUND
The aim of this study was to evaluate the impact of an intervention designed to improve postoperative pain assessment and recording by nurses.


METHODS
This cluster randomized clinical trial included two intervals of 3 months each: a preintervention observational study (period 1) followed by a period of intervention (period 2). Six surgical wards were randomly assigned to receive either an experimental intervention, including educational seminars for nurses on pain, pain assessment and the use of a visual analogue scale (n = 3), or standard care (control group; n = 3). The main outcome measures were the percentage of patients in whom pain was assessed, number of pain assessments per patient and postoperative pain intensity scores.


RESULTS
A total of 2278 patients were included. Significant improvements were found in the percentage of patients in whom pain was assessed and the number of daily pain assessments per patient in the intervention group between periods 1 and 2. In contrast, these outcomes were unchanged between the two intervals in wards randomized to standard care. During period 2, pain scores at 48 h were significantly decreased in the intervention wards compared with those in the control group.


CONCLUSIONS
An educational programme dedicated to nurses strongly increased the use of regular pain assessment, and may have contributed to a modest improvement in postoperative analgesia.
Ravaud
P
P
Département d'Epidémiologie et INSERM EMI 0357, Faculté Lariboisière-Saint-Louis (Université Paris 7) et INSERM ERM 0321, Paris, France.
Keïta
H
H
Porcher
R
R
Durand-Stocco
C
C
Desmonts
J M
JM
Mantz
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence / Q000592:standards*; D004506:Education, Nursing / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D010149:Postoperative Pain / Q000451:nursing*; D011446:Prospective Studies; D016896:Treatment Outcome