Parental involvement in postoperative pain management among children in a urology ward: A best practice implementation project.

ABSTRACT

AIM: Postoperative pain has adverse effects on children with urological problems, including sleep disturbances, incision dehiscence, bleeding and delayed recovery. Accurate parental assessment of children's behaviours and responses could help to manage postoperative pain. We aimed to implement evidence-based practice for parental involvement in a urology ward, to increase parents' participation in children's postoperative pain management. DESIGN: The project was conducted in a paediatric urology ward using the framework and methods of the Fudan University Evidence-Based Nursing Center's Evidence-based Continuous Quality Improvement Model. METHODS: Fifteen audit criteria were used to represent best practice recommendations for parental involvement in postoperative pain management. A pre-implementation audit was conducted with 211 randomly sampled children and parents. Obstacles, promoting factors and key strategies were analysed, and evidence-based interventions implemented to improve compliance. A follow-up audit using the same audit criteria was conducted with 202 children and parents to assess the effect of targeted strategies on compliance with best practice. The SQUIRE guidelines were followed. RESULTS: At the baseline audit, compliance with the evidence-based criteria was 0%-71.5%; only five audit criteria achieved a compliance rate > 60%. After best practice implementation, the follow-up audit showed compliance improvements for all criteria; compliance for three criteria improved to 100%. PATIENT OR PUBLIC CONTRIBUTION This best practice implementation project improved parents' participation in children's postoperative pain management. The findings demonstrate how audits can promote best practice in postoperative pain management for children. Additional studies will be conducted to address children's postoperative life quality based on best practice.