Management of Postoperative Pain in Medical Institutions in Shandong Province in China

Abstract

The aim of the study was to investigate current situation of postoperative pain management in medical institutions in Shandong Province.A questionnaire was developed on the basis of guidelines of acute pain and pain quality assessment scale. The questionnaire was used to obtain information regarding the nature and scale of the medical institution, structure of pain management organization, implementation of pain assessment, and analgesic techniques and processes used in clinical practice. A multistage stratified and cluster sampling method was employed to investigate the current situation of postoperative pain management in 168 medical institutions in Shandong Province.For acute pain service (APS), 32% of the hospitals established postoperative pain management organizations similar to APS. For pain evaluation, 57.1% of the hospitals evaluated pain as the fifth vital sign, and 47.0% of the hospitals evaluated pain at rest and during activity. Furthermore, 43.0% of the surveyed hospitals employed patient-controlled analgesia mode, of which hospitals employing brachial plexus block, lumbar plexus block, and femoral nerve block analgesia accounted for 5.0%, 1.0%, and 4.0%, respectively. The survey revealed that 51.0% of the hospitals educated patients about pain and pain management, of which patients were postoperatively educated by ward nurses in 5.0% and patients were educated by APS during ward rounds in 2.0%.There is a lack of standardized postoperative pain management, the involvement of nurses in pain management is scarce, and the pain assessment and education and application of advanced analgesic management techniques were found to be inadequate in medical institutions in Shandong Province.

Avaliação do diagnóstico de enfermagem “dor aguda” em pacientes internados em uma clínica médico-cirúrgica

“…Autores verificaram forte associação entre as alterações fisiológicas, causadas por cirurgias de grande porte, principalmente ortopédicas, e a presença de dor pós-operatória (17) . Embora a dor, no período pós-operatório, necessite de grande atenção e cuidados, seu manejo é inadequado, na maioria das vezes, tendo a equipe de enfermagem pouco envolvimento em sua avaliação e controle, sendo necessária maior capacitação dos profissionais para o uso de estratégias avançadas no cuidado com a dor (18) .…”

Análise da intensidade, aspectos sensoriais e afetivos da dor de pacientes em pós-operatório imediato

“…Patients who underwent cancer, trauma, haemodynamic, and vascular surgery reported a greater intensity of pain when admitted to the PARU, with statistical significance (p< 0.01) than the other patients. With regard to intensity of the pain, at the patient admission, the "worst possible pain" was reported by 4.8% (16) of the patients, "intense" by 7.1% (24), "moderate" by 24.1% (81), and "mild " by 4.8% (16). A total of 58.6% (197) participants did not report pain.…”

“…Given the significant number of patients who reported pain in the immediate postoperative period, it must be the focus of nursing staff and multi-professional teams. A study in China investigated the management of postoperative pain in 168 medical institutions in Shandong province and revealed a lack of standardised management of postoperative pain with little involvement of the nurses in the assessment of pain and its control, and the education of staff members for the use of advanced pain care techniques (16) . Analgesia can hasten recovery, increase patient collaboration with treatment, and improve post-surgery outcomes (12) .…”

Implementation and evaluation of a pain management core competency education program for surgical nurses

“…In order to effectively manage the pain of postoperative patients, surgical nurses need good knowledge and skills of pain assessment and management, and to implement pain assessments, provide analgesic and nonpharmacologic interventions, and monitor analgesic effects and adverse reactions [ 12 ]. Although nurses have some educational opportunities for pain management, studies indicate there were obvious deficits in knowledge and competencies related to pain management in nurses in China [ [13] , [14] , [15] ].…”