Background & Aims
Inadequate pain management can lead to physiological stress due to continuous pain and when it occurs postoperatively, it increases the risk of complications and a longer rehabilitation period. The nursing team plays a fundamental role in pain management because they are health professionals who act in the first line of care and are sometimes the first to assess the patient’s pain, therefore, pain assessment and care are essential skills and fundamental to the quality of nursing care for the patient, so this study aim Implement an improvement plan for pain management carried out by nurses with an action prioritization matrix.
Methods
This is an implementation study with a before-and-after design, carried out from 2022 to 2024 at a national institute for orthopedic surgeries. The study will be based on the JBI Implementation Model. The approach to implementation is based on the process of audit, feedback, re-audit and an approach to identifying and managing barriers to change and is divided into 7 phases. To carry out the baseline audit, evidence of best practices was used. The study participants are nurses who work in adult perioperative care units, patients hospitalized during the data collection period and an audit was carried out on the medical records of patients participating in the study. Based on the results of the baseline audit, an improvement plan was developed for nursing practices used in pain management in orthopedic surgical patients, and products were developed for nurses (Course on institutional platform) and patients (Educational material).
Results
A baseline audit was conducted with 18 nurses, 30 patients and 30 medical records. In interviews with patients, 60% reported having their pain reassessed after any relief measure and 33% felt the need to receive more medication to control pain, when compared with the nurses’ response, 100% responded to provide individualized care, taking into account the needs and patient preferences, while in the medical record audit, only 30% presented a record of goals and individual treatment plans for postoperative pain control. Regarding the use of multimodal therapy and non-pharmacological practices, 100% of patients’ nurses stated that they use it in practice, but the registration only occurred in 6.7% of the medical records. The improvement plan and developed products are being implemented. A follow-up audit will be carried out to assess whether there has been an increase in the percentage of compliance concerning best practices, and strategies to monitor sustainability of the change.
Conclusions
The process of implementing an improvement based on best practices and adapted to the local reality, brings safety and quality to the care provided since safe management of acute pain requires coordination and consistency at all levels. Products: Improvement plan for pain management carried out by nurses during the postoperative period of orthopedic surgery; Course on the institution’s virtual learning platform and educational material for patients.
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Presenting Author
Barbara Ventura Fontes
Poster Authors
Barbara Ventura Fontes
Master's Degree student
Federal Fluminense University and National Institute of Traumatology and Orthopedics
Lead Author
Erica Brandão de Moraes
PhD
Federal Fluminense University
Lead Author
Amanda Magalhães de Oliveira
Nursing Student
Federal Fluminense University
Lead Author
Maria Fernanda Muniz Ferrari
PhD Student
Federal Fluminense University and Nacional Institute of Traumatology and Orthopedics
Lead Author
Juliane de Macedo Antunes
PhD
Nacional Institute of Traumatology and Orthopedics
Lead Author
Marina de Almeida Geraldo
Nacional Institute of Traumatology and Orthopedics
Lead Author
Topics
- Evidence, Clinical Trials, Systematic Review, Guidelines, and Implementation Science