Quality control programme for acute pain management in emergency medicine: a national survey.
OBJECTIVE
This national survey was carried out to evaluate the quality programme for acute pain management in the emergency department (ED) and in pre-hospital emergency medical services (EMS).


METHODS
Two types of questionnaires were sent to the chief consultant and the chief nurse of all ED and EMS. Data collected were: the type of structure, quality programme organization, acute pain management, and the training needs to initiate a pain quality programme.


RESULTS
A total of 363 questionnaires were recorded (198 from chief consultants) with 98% of questionnaires being usable. A pain management committee existed in 71% of cases, a quality committee in 83%. A complete quality control procedure existed in 53% of units. An audit on pain management was carried out in only 23% of cases. Training in quality was performed for 64% of physicians and 68% of nurses. Training specifically for pain management was carried out for physicians in 56% of cases and for nurses in 68% of cases. Pain therapeutics protocols existed in 69% of cases. Pain intensity was evaluated 'systematically or often' in 64% at the beginning of patient management, and in 56% at the end of patient management. The staff was 'not very motivated' for a pain management quality programme in less than 3% of responses. A total of 61% of chief consultants and 58% of chief nurses requested advice.


CONCLUSIONS
Most ED and EMS units seem to master the quality control programme methodology. Units are highly motivated to initiate a quality control programme on pain. Nevertheless, its implementation could benefit from some external support.
Ricard-Hibon
Agnes
A
Department of Anaesthesiology and Intensive Care, Beaujon University Hospital, Clichy, France. agnes.ricard@bjn.ap-hop-paris.fr
Ducassé
Jean-Louis
JL
Ravaud
Philippe
P
Wood
Chantal
C
Viel
Eric
E
Chauvin
Marcel
M
Brunet
Fabrice
F
Bleichner
Gérard
G
D000208:Acute Disease; D004635:Emergency Medicine / Q000193:education / Q000592:standards*; D004636:Emergency Service, Hospital / Q000592:standards*; D005602:France; D019538:Health Care Surveys; D006801:Humans; D008332:Management Quality Circles; D008485:Medical Audit; D009731:Nursing Audit; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires