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Analgesic Outcomes in a Danish Acute Care Hospital Following Electronic Prescribing and Analgesic Self-Administration.
Botti, Mari A; Rasmussen, Bodil; Khaw, Damien A; Kristensen, Ingrid V; Esmarch, Elsebeth B; Hutchinson, Anastasia F.
Afiliação
  • Botti MA; Centre for Quality & Patient Safety Research Epworth HealthCare Partnership, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.
  • Rasmussen B; Centre for Quality & Patient Safety Research Epworth HealthCare Partnership, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia; Surgical Department, Centre for Research and Education in Health, Regional Hospital, West Jutland, Denmark.
  • Khaw DA; Centre for Quality & Patient Safety Research Epworth HealthCare Partnership, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia. Electronic address: Damien.Khaw@deakin.edu.au.
  • Kristensen IV; VIA Faculty of Health Sciences, Holstebro, Denmark.
  • Esmarch EB; Surgical Department, Centre for Research and Education in Health, Regional Hospital, West Jutland, Denmark.
  • Hutchinson AF; Centre for Quality & Patient Safety Research Epworth HealthCare Partnership, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.
Pain Manag Nurs ; 21(4): 345-353, 2020 08.
Article em En | MEDLINE | ID: mdl-32063502
ABSTRACT

BACKGROUND:

Despite the long-term consequences of poorly controlled postoperative pain, inadequate pain control remains a problem.

AIMS:

To improve the quality of postoperative pain management, the study site, an acute care hospital in Denmark, introduced electronic prescribing with standard order-sets, and allowed patients to self-administer analgesia. This study aimed to describe analgesic prescribing, prescriptions for multimodal analgesia, analgesic administration, and patients' pain experience, in this context.

DESIGN:

Point-prevalence survey. SETTINGS One Danish regional hospital.

PARTICIPANTS:

Consecutive sample of 286 surgical inpatients comprising 65 orthopaedic, 41 gynaecological, 57 urology and 123 gastrointestinal patients.

METHODS:

We evaluated the quality of postoperative pain management on four postoperative surgical wards using (1) the Revised American Pain Society Patient Outcome Questionnaire; and (2) patient chart audit.

RESULTS:

Overall, 89.2% of patients were prescribed a fixed analgesic and 71.7% were prescribed fixed analgesics in multimodal combination. Patterns of multimodal prescribing and administration varied significantly across surgical groups. Patients received 87.7% of available fixed prescriptions and 22.5% of available analgesics prescribed 'as needed'. However, patients' worst pain intensity was high (mean = 5.8/10, SD = 2) and 73.4% reported moderate-to-severe worst pain during the previous 24-hours. Patients who self-administered medications used significantly more fixed-schedule paracetamol (p = .018), non-steroidal anti-inflammatory drugs (p = .001), weak (p = .035) and strong (p < .001) opioids.

CONCLUSIONS:

The availability of multimodal analgesia was high following the introduction of electronic prescribing. However, gaps remain in the administration of both fixed and 'as needed' analgesics for postoperative patients. Findings suggested that allowing patients to self-administer analgesia may increase compliance with fixed schedule prescriptions.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Prescrição Eletrônica / Analgésicos Tipo de estudo: Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Pain Manag Nurs Assunto da revista: ENFERMAGEM / NEUROLOGIA / PSICOFISIOLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Austrália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Prescrição Eletrônica / Analgésicos Tipo de estudo: Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Pain Manag Nurs Assunto da revista: ENFERMAGEM / NEUROLOGIA / PSICOFISIOLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Austrália