Postoperative pain management - the influence of surgical ward nurses.
OBJECTIVE
To compare pain levels reported by patients with those documented by ward nurses and to find out to what extent the amount of opioids given correlated with the pain level. Secondly, to study if pain management and nurses' approaches to this task had improved during a two-year period, including an educational pain treatment program for ward staff.


BACKGROUND
The management of postoperative pain continues to remain problematic and unsatisfactory and ward nurses play an important role for this task.


METHODS
The study was a cross-sectional, descriptive, two-part study based on survey data from both patients and nurses on two urology surgical wards.


METHODS
Part I of the study included 77 patients and 19 nurses. Part II took place approximately two years later and included 141 patients and 22 nurses. Data were collected the day after surgery by asking patients about 'worst pain' experienced. The pain scores given by the patients were compared with those documented in the patients' records and with the doses of opioids administered. Nurses' approaches to pain management were sought after, by using a categorical questionnaire.


RESULTS
The nurses' ability to assess pain in accordance with the patients' reports had increased slightly after two years even if and the number of documented pain scores had decreased. Forty per cent of the nurses reported that they did not use visual analogue scale and that they did not assess pain at both rest and activity, neither did one fourth evaluate the effect of given analgesics.


CONCLUSIONS
The study showed a discrepancy in pain scoring between nurses and patients, where active treatment was related to nurses' documentation rather than to patients' scoring.


CONCLUSIONS
The study shows a need for more accurate pain assessment, since the patient experiences and suffers pain and the nurse determines upon treatment.
Ene
Kerstin Wickström
KW
The Sahlgrenska Academy at Gothenburg University, Institute of Health and Care Sciences and Department of Anesthesiology, Sahlgrenska University Hospital, Gothenburg, Sweden. kerstin.wickstrom.ene@vgregion.se
Nordberg
Gunnar
G
Bergh
Ingrid
I
Johansson
Fannie Gaston
FG
Sjöström
Björn
B
D000328:Adult; D000698:Analgesia / Q000379:methods / Q000451:nursing / Q000523:psychology; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004509:Education, Nursing, Continuing; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology; D009730:Nursing Assessment / Q000379:methods; D015402:Nursing Education Research; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D010147:Pain Measurement / Q000379:methods / Q000451:nursing / Q000523:psychology; D010149:Postoperative Pain / Q000175:diagnosis / Q000451:nursing / Q000523:psychology; D013527:Perioperative Nursing / Q000193:education / Q000458:organization & administration; D011182:Postoperative Care / Q000193:education / Q000379:methods / Q000451:nursing / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013548:Sweden; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000451:nursing / Q000523:psychology
D000701:Analgesics, Opioid