Improving postoperative pain management in children by providing regular training and an updated pain therapy concept

Abstract

Background: In recent years, children's hospitals have increasingly implemented postoperative pain management protocols to reduce postoperative pain and improve patient satisfaction. The effectiveness and long-term sustainability of such protocols have rarely been studied. Therefore, we conducted a prospective intervention study to assess the impact of regular training and improvement of clinical processes on the quality of postoperative pain management. Methods: We conducted an initial assessment of the status quo of postoperative pain management (Audit 1) followed by repeated training and improvement of clinical processes (analgesic pocket card, parents' brochure, modification of the patient chart, bimonthly advanced trainings sessions) and a follow-up review after 3 years (Audit 2). We used a data entry form, a patient survey, and an anonymous questionnaire for the nursing staff as measurement tools. Results: Our analysis included a total of 93 and 85 patients in the initial and final audits. The return rates of the nursing staff questionnaire were 83% (Audit 1) and 77% (Audit 2). The training and process improvements resulted in significant improvement in the administration of analgesics for pain requiring treatment, the control of pain measurement after the administration of analgesics and the use of non-pharmacological pain therapies. The patients reported faster administration of analgesics for acute pain and improved pain relief following the intervention. Conclusions: Repeated training and improvement of clinical processes can significantly improve the long-term quality of postoperative pain management in children with a tolerable amount of effort on the part of health care professionals and institutions.

Pain Management in the Context of a Nursing Help Line: Identification of Needs, Development of a Continuing Education Activity, and Evaluation of its Impact

“…Because non-pharmacological approaches can be initiated autonomously, many of the participants mentioned how the acquired knowledge about those interventions had been useful during their phone interventions. In this respect, the results of our study corroborate those of other research showing that CE helps to increase the use of non-pharmacological approaches in the treatment of pain (Lin et al, 2008;Heinrich, Mechea, & Hoffmann, 2016). This also supports one of the recommendations of Bergeron et al (2015) suggesting that pain management CE could mitigate the lack of use of non-pharmacological approaches to treat pain.…”

Using ways of knowing in nursing to develop educational strategies that support knowledge mobilization

“…Only four studies within the last five years explored the effect of pain education on pediatric nurses’ pain management behaviors. Three studies showed improvements in analgesic drug prescribing 27 , analgesic drug administration 28 , and compliance with pain‐related palliative care clinical guidelines 29 . The other study did not find any improvements in pain assessment behavior following an educational intervention 19 …”

<br /> MEDIDAS NÃO FARMACOLÓGICAS NA PESSOA COM DOR: RESULTADOS SENSÍVEIS DA INTERVENÇÃO DOS ENFERMEIROS REVISÃO SISTEMÁTICA DA LITERATURA

“…Quanto aos enfermeiros, diversos artigos demonstram que estes profissionais apresentam formação e capacitação reduzida em gestão da dor e em medidas não farmacológicas, propondo maior investimento em formação contínua (26,27,28) . Neste sentido, da análise, verifica--se que os grupos experimentais que incluíram formação aos enfermeiros em dor e medidas não farmacológicas obtiveram melhor controlo da intensidade da dor, bem como maior utilização de medidas não farmacológicas, face aos respetivos grupos controlo (21,23) .…”