A Quality Assurance Plan for an Epidural Analgesia Program

Exploring the impact of Acute Pain Teams (APTs) on patient outcomes using routine data

“…Whilst some APTs may restrict their role to the management of PCA and epidurals, others have a much broader remit, covering a variety of elements of post-operative pain management. Each of these elements of their remit have been purported to contribute to a more effective APS, and include staff training (Rawal, 1994b;Ferguson, 1995b;McLeod et al, 1995;Notcutt and Austin, 1995;Coleman and Booker-Milburn, 1996;Mackintosh and Bowles, 1997;Chen et al, 1998;Tighe et al, 1998), development of guidelines and protocols (Williams et al, 1991;Hall and Bowden, 1996;Humphries et al, 1997;Pesut and Johnson, 1997;Wong et al, 1997), introduction of algorithms to increase the effectiveness of IM analgesia (Gould et al, 1992), introduction of pain and sedation scoring systems (Wheatley et al, 1991;Gould et al, 1992;Rawal 1994aRawal , 1994bTsui et al, 1995;Mackintosh and Bowles, 1997;Tighe, et al, 1998), audit and research (Wheatley et al, 1991;Hughes and Rawal, 1994;Hall and Bowden, 1996;Watts, 1998;Rawal, 1999) and patient teaching and information-giving (Coleman and Booker-Milburn, 1996;Gabrielczyk and McGonagle, 1997;Mackintosh and Bowles, 1997). In some cases, as part of ongoing educational programmes, APTs have also established 'link nurse' systems, where a named nurse on each surgical ward is given additional training and responsibility in acute pain management, sometimes accompanied by an accredited qualification.…”