Nurses' reassessment of postoperative pain after analgesic administration.
OBJECTIVE
To identify when and how nurses reassess patients' pain after analgesic administration in the postoperative context.


METHODS
Fifty-two nurses were observed caring for postoperative patients (N=364) in 2 surgical settings in a major metropolitan hospital. Seventy-four observation periods of 2 hours duration were studied. The research assistant observed nurses' activities in caring for the allocated patients', detailing behavioral and verbal responses onto audiotape.


RESULTS
Of the 316 pain activities that occurred in 74 observation periods, 14 (4.4%) were reassessments after analgesic administration. Four themes were evident from the 14 reassessments: opportunistic reassessment, the use of simple questioning, a focus on surgical wound pain not procedural pain, and nurse-initiated reassessment.


CONCLUSIONS
Despite the focus on meeting standards of care in the area of pain management, there was an extraordinary lack of patient reassessment by nurses after the administration of analgesics. Given the raised awareness internationally on assessment generally and a lack of evidence focused on reassessment after an intervention, this may explain why research is failing to identify shifts in pain severity scores and indeed patient pain.
Bucknall
Tracey
T
School of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Level 1, 723 Swanston Street, Carlton, Victoria, Australia 3053. bucknall@unimelb.edu.au
Manias
Elizabeth
E
Botti
Mari
M
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009732:Nursing Care / Q000592:standards*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D010166:Palliative Care / Q000592:standards*
D000700:Analgesics