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Management of acute postoperative pain in Australian hospitals - room for improvement


Taylor, DR and Loh, SF and Mulligan, KT and Pulver, LK and Tompson, AJ and Wai, A, Management of acute postoperative pain in Australian hospitals - room for improvement, Journal of the Australasian Association for Quality in Health Care, 2010, (Summer) pp. 29-36. ISSN 1440-2599 (2010) [Refereed Article]

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Copyright 2010 AAQHC

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Objective: To describe a quality improvement initiative in the management of acute postoperative pain in Australian hospitals. Design: Multicentre, cross-sectional, retrospective inpatient medical record review and post-discharge surveys of patients and their General Practitioners (GPs), conducted between October 2006 and October 2007, before and after targeted educational intervention. Setting: 62 Australian hospitals - representing the spectrum of regional/remote to principal referral and including private and specialist hospitals. Participants: Up to 50 adults undergoing emergency/elective surgery per hospital, in each of baseline and follow-up phases. Outcome measures: Documented preoperative education; pain and sedation assessment; safe and effective analgesic prescribing and communication of a pain management plan to patients/carers and their GPs at discharge. Results: 2704 baseline (2780 follow-up) patients were included. Documentation of preoperative education regarding postoperative pain was noted for 31% (44%) of patients. 57% (76%) of patients had at least one pain score documented in the postoperative data collection period. Of patients prescribed analgesia, 68% (74%) were prescribed regular paracetamol and 23% (18%) only as needed analgesia. Of patients prescribed opioids, 50% (61%) had at least one documented sedation score and 87% (90%) were prescribed an antiemetic agent. Discharge pain management plans were documented for 26% (40%) of patients and of these, 86% (87%) were communicated to patients and 71% (77%) to GPs. Conclusions: Targeted interventions including one-on-one educational visiting and feedback of comparative data improved some key outcome measures; performance and documentation of preoperative education, post-operative pain and adverse event assessment and discharge communication with patients and GPs.

Item Details

Item Type:Refereed Article
Keywords:postoperative pain, quality improvement, continuum of care
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health services and systems not elsewhere classified
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health and support services not elsewhere classified
UTAS Author:Tompson, AJ (Miss Anna Tompson)
ID Code:65365
Year Published:2010
Deposited By:Pharmacy
Deposited On:2010-11-09
Last Modified:2011-07-27
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