title: [The ECAD_O project: clinical caring epidemiology of pain in the hospital: the nurses' contribution].
abstract: OBJECTIVE
  ECAD_O is a project aimed to establish a surveillance of pain treatment--as part of routine care and as a hospital pharmacovigilance activity--with the following objectives: to assess in each participant ward prevalence of patients exposed to analgesics; to describe the pharmacological management schedules; to document the perception of health-care professionals on the effectiveness of treatment administered; to identify groups of patients whose pain is undertreated, through the activation of a collaborative protocol.
  
  
  METHODS
  A multicentre (48 hospitals) and multidisciplinary (nurses, clinicians, pharmacists) cross-sectional survey was conducted in 6 index-days. Epidemiological, clinical and therapeutic data were collected and heath-care professionals (nurses or clinicians) were asked about their perception on the effectiveness of treatment administered and the reasons of non-effectiveness.
  
  
  RESULTS
  In the 164 participant wards (61 surgery, 46 medicine, 28 oncology, 22 orthopaedics, 7 other) 3854 patients (20.9% of inpatients) were exposed to analgesics. The majority of patients (84.3%) received analgesics around-the-clock. Opioid analgesics were administered around-the-clock (64.7%; 2103/3250) as well as only as needed (27.1%; 164/604). According to health-care professionals, analgesic therapy administered was not effective in 516 patients (13.4% of sample). Inspite of this evaluation, 288 patients did not receive rescue therapy, because it was not prescribed (180 patients) or not administered even if prescribed (108 patients).
  
  
  CONCLUSIONS
  The establishment of a surveillance scheme which could be adopted in the routine conditions of care to monitor the quality of pain control has been successfully tested on the basis of multidisciplinary teams where the nurse personnel plays a key role.
authors.affiliation: Centro Studi SIFO, Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti.
authors.forename: Daniela
authors.initials: D
authors.lastname: Sichetti
authors.forename: Katiuscia
authors.initials: K
authors.lastname: Di Biagio
authors.forename: Nadia
authors.initials: N
authors.lastname: Anino
authors.forename: Rosalia
authors.initials: R
authors.lastname: Buttà
authors.forename: Cristina
authors.initials: C
authors.lastname: Venturi
authors.forename: Elena
authors.initials: E
authors.lastname: Bandieri
authors.forename: Carla
authors.initials: C
authors.lastname: Ripamonti
authors.forename: Gianni
authors.initials: G
authors.lastname: Tognoni
authors.forename: Marilena
authors.initials: M
authors.lastname: Romero
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology* / Q000451:nursing*; D011159:Population Surveillance