Improving Pain Management after Total Joint Replacement Surgery

An Investigation of the Effects of Preoperative Interdisciplinary Patient Education on Understanding Postoperative Expectations Following a Total Joint Arthroplasty

“…Patients have reported moderate or severe postoperative pain, and patient telephonic surveys after discharge reveal that pain management needs were not met. Pain management for orthopaedic surgical patients demands evidence-based content and strategies involving direct care providers to ensure consistent use of pain management principles (Neitzel et al, 1999). In contrast to prior findings, this study revealed that overall both groups reported fairly low levels of pain (less than 4 on a 0-10 scale) on the second postoperative day.…”

“…Eighty three percent of such patients reported moderate or severe postoperative pain, and telephone surveys after discharge revealed that pain management needs were not met (Neitzel, Miller, Shepherd, & Belgrade, 1999). Unrelieved postoperative pain continues to be a major clinical problem (Sloman, Rosen, Rom, & Shir, 2005).…”

Length of Stay, Discharge Disposition, and Hospital Charge Predictors

“…One study found that postoperative pain, epidural versus IV postoperative analgesia, and analgesia side effects were not significantly related to LOS 12 . This is contradicted somewhat by another study that found LOS decreased significantly with the use of a pain management program that controlled postoperative pain more efficiently 18 . In contrast, a third study found that patients who received epidural analgesia postoperatively had decreased LOS when compared with patients who received two other types of postoperative analgesia 19 …”

The unique contribution of the nursing intervention pain management on length of stay in older patients undergoing hip procedures

“…Numerous studies demonstrate a link between medical management of pain, including use of various blocks, patient-controlled analgesia, type of analgesic used, and LOS (Chelly, Gebhard, Coupe, Greger, & Khan, 2001; Ilfeld, Morey, & Enneking, 2002; Ilfeld, Morey, Wang, & Enneking, 2002). Neitzel, Miller, Shepherd, and Belgrade (1999) had similar results with hip and knee replacement inpatients, demonstrating significantly decreased LOS after implementation of evidence-based postoperative pain management practices, including education of physician and nurse providers and system changes at the point of care. However, little is known concerning the unique contribution of nursing interventions to LOS following hip procedures.…”

“…The literature suggests that effective pain management in hip procedure patients is associated with a decreased LOS (Chelly et al, 2003; Neitzel et al, 1999; Pavlin et al, 1998; Pavlin et al, 2002). One explanation for the unexpected finding is that pain may be an indicator of procedural complications or delayed healing.…”