Oligoanalgesia in the emergency department: short-term beneficial effects of an education program on acute pain.

Détails

ID Serval
serval:BIB_AF2D6A3F434A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Oligoanalgesia in the emergency department: short-term beneficial effects of an education program on acute pain.
Périodique
Annals of emergency medicine
Auteur(s)
Decosterd I., Hugli O., Tamchès E., Blanc C., Mouhsine E., Givel J.C., Yersin B., Buclin T.
ISSN
1097-6760[electronic]
Statut éditorial
Publié
Date de publication
2007
Volume
50
Numéro
4
Pages
462-471
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Résumé
STUDY OBJECTIVE: Acute pain is the most frequent complaint in emergency department (ED) admissions, but its management is often neglected, placing patients at risk of oligoanalgesia. We evaluate the effect of the implementation of guidelines for pain management in ED patients with pain at admission or anytime during their stay in our ED. METHODS: This prospective pre-post intervention cohort study included data collection both before and after guideline implementation. Consecutive adult patients admitted with acute pain from any cause or with pain at any time after admission were enrolled. The quality of pain management was evaluated according to information in the ED medical records by using a standardized collection form, and its impact on patients was recorded with a questionnaire at discharge. RESULTS: Two hundred forty-nine and 192 patients were included during pre- and postintervention periods. Pain was documented in 61% and 76% of nurse and physician notes, respectively, versus 78% and 85% after the intervention (difference 17%/9%; 95% confidence interval [CI] 8% to 26%/2% to 17%, respectively). Administration of analgesia increased from 40% to 63% (difference 23%; 95% CI 13% to 32%) and of morphine from 10% to 27% (difference 17%; 95% CI 10% to 24%). Mean doses of intravenous morphine increased from 2.4 mg (95% CI 1.9 to 2.9 mg) to 4.6 mg (95% CI 3.9 to 5.3 mg); administration of nonsteroidal antiinflammatory drugs and acetaminophen increased as well. There was a greater reduction of visual analogue scale score after intervention: 2.1 cm (95% CI 1.7 to 2.4 cm) versus 2.9 cm (95% CI 2.5 to 3.3 cm), which was associated with improved patient satisfaction. CONCLUSION: Education program and guidelines implementation for pain management lead to improved pain management, analgesia, and patient satisfaction in the ED.
Mots-clé
Acute Disease, Adult, Analgesia, Data Collection, Education, Medical, Continuing, Emergency Service, Hospital, Guideline Adherence, Hospitals, Teaching, Humans, Pain, Patient Satisfaction, Practice Guidelines as Topic, Prospective Studies, Switzerland
Pubmed
Web of science
Création de la notice
29/01/2008 9:41
Dernière modification de la notice
20/08/2019 16:18
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