title: The pain experience of post surgical patients following the implementation of an evidence-based approach.
abstract: Effective pain management has been shown to promote earlier mobilization, adequate rest, reduced hospital stays, postoperative complications, and costs. A multidisciplinary quality improvement team worked together to develop and implement a comprehensive evidence-based program for postoperative pain management. The purpose of this study was to assess surgical patients' pain status, satisfaction, and beliefs with regard to pain management prior to (Phase 1) and following the implementation of the program (Phase II). On postoperative day two, patients rated their pain, its impact on their activity, and answered questions about pain management and their satisfaction with pain treatment. Significant differences were found between Phase I and Phase II patients. More patients in Phase II (83%) received evidence-based orders compared with patients in Phase I (35%). Patients in Phase II had lower pain scores and experienced fewer disturbances in sleep, walking, and general activities. Patients in Phase II were less likely to believe that good patients avoid talking about pain. The results suggest that addressing pain management through a variety of strategies targeted at the level of the institution, the clinician, and the patient may lead to desired changes in practice and better outcomes for patients.
authors.affiliation: Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada. dbedard@nurs.jgh.mcgill.ca
authors.forename: Denise
authors.initials: D
authors.lastname: Bédard
authors.forename: Margaret Ann
authors.initials: MA
authors.lastname: Purden
authors.forename: Nicole
authors.initials: N
authors.lastname: Sauvé-Larose
authors.forename: Cynthia
authors.initials: C
authors.lastname: Certosini
authors.forename: Constance
authors.initials: C
authors.lastname: Schein
mesh_terms: D000208:Acute Disease; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D015400:Clinical Nursing Research; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D015279:Organizational Culture; D009936:Organizational Innovation; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D010348:Patient Care Team / Q000458:organization & administration*; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic / Q000592:standards*; D016730:Program Development; D015397:Program Evaluation; D011792:Quebec; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000458:organization & administration; D016896:Treatment Outcome