The quality of postoperative pain management from the perspectives of patients, nurses and patient records.
OBJECTIVE
To study the quality of postoperative pain management in a university hospital.


METHODS
Paired patient and nurse assessments of the patient's pain management were conducted in two departments, complemented with audit of patient records. The Strategic and Clinical Quality Indicators in Postoperative Pain Management questionnaire was answered by 121 patients and 47 Registered Nurses.


RESULTS
Of 14 items in the Strategic and Clinical Quality Indicators in Postoperative Pain Management questionnaire, four items in general surgery and five items in thoracic surgery reached the threshold for high quality of care. No significant differences were found between the assessments in the two departments, but the patients in general surgery experienced more pain than the patients in thoracic surgery. In general surgery, the patients assessed their worst pain significantly higher than the nurse did. The patients who experienced more pain than expected were less satisfied with the quality of their care and experienced higher pain intensity levels. For 25 (41.0%) patients in general surgery and four (6.7%) patients in thoracic surgery, pain intensity was documented according to hospital quality goals.


CONCLUSIONS
In both departments, areas for improvements could be found in all subscales of the Strategic and Clinical Quality Indicators in Postoperative Pain Management questionnaire, i.e. communication, action, trust and environment. It is important to discuss what information the patient needs, as well as how and when it should be given. Furthermore, considering earlier pain experience and the goal of pain relief for the individual patient may facilitate an adequate assessment of the patient's pain. In future, electronic health records have the potential to support the use of clinical guidelines.
Gunningberg
Lena
L
Surgery Division, University Hospital, and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. lena.gunnningberg@akademiska.se
Idvall
Ewa
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000592:standards; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010147:Pain Measurement / Q000451:nursing / Q000523:psychology / Q000592:standards; D010149:Postoperative Pain / Q000451:nursing / Q000523:psychology; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000451:nursing / Q000523:psychology / Q000592:standards; D019984:Quality Indicators, Health Care / Q000592:standards*; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013548:Sweden