title: Increasing patient knowledge on the proper usage of a PCA machine with the use of a post-operative instructional card.
abstract: OBJECTIVE
  The purpose of this study was to see if an instructional card, attached to the PCA machine following total hip arthroplasty describing proper use of the device, would positively affect subjects' understanding of device usage, pain scores, pain medication consumption and satisfaction.
  
  
  METHODS
  Eighty adults undergoing total hip replacements who had been prescribed PCA were randomized into two study groups. Forty participants received the standard post-operative instruction on PCA device usage at our institution. The other 40 participants received the standard of care in addition to being given a typed instructional card immediately post-operatively, describing proper PCA device use. This card was attached to the PCA device during their recovery period. On post-operative day one, each patient completed a questionnaire on PCA usage, pain scores and satisfaction scores.
  
  
  RESULTS
  The pain scores in the Instructional Card group were significantly lower than the Control group (p = 0.024). Subjects' understanding of PCA usage was also improved in the Instructional Card group for six of the seven questions asked.
  
  
  CONCLUSIONS
  The findings from this study strongly support that postoperative patient information on proper PCA use by means of an instructional card improves pain control and hence the overall recovery for patients undergoing surgery. In addition, through improved understanding it adds an important safety feature in that patients and potentially their family members and/or friends may refrain from PCA-by-proxy. This article demonstrates that the simple intervention of adding an instructional card to a PCA machine is an effective method to improve patients' knowledge as well as pain control and potentially increase the safety of the device use.
authors.affiliation: a Department of Anaesthesia , Royal Free Hospital NHS Foundation Trust , London , UK.
authors.forename: Louisa
authors.initials: L
authors.lastname: Shovel
authors.affiliation: b American Anesthesiology of North Carolina , Wake Med Practice Center , Raleigh , NC , USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Max
authors.affiliation: c Department of Anesthesiology , Perioperative and Pain Medicine, Brigham and Women's Hospital , Boston , MA , USA.|d Department of Anaesthesia , Harvard Medical School , Boston , MA , USA.
authors.forename: Darin J
authors.initials: DJ
authors.lastname: Correll
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods* / Q000523:psychology; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011184:Postoperative Period; D012646:Self Administration; D016896:Treatment Outcome
keywords: Education; Knowledge; Patient-controlled Analgesia; Postoperative Pain; Safety