75 Audit of Pain Control in Surgical Inpatients
Abstract
Pain is a significant feature in surgical patients and is complicated by multiple underlying mechanisms and co-morbidities. Optimal pain control is an important feature of care as prolonged pain can impair quality of life, reduce mobility, healing, delay hospital discharge and cause detrimental pathophysiological changes. The aim of audit is to assess the quality of pain control including side effects of analgesics in surgical inpatients at Lincoln County Hospital NHS Trust.
Prospective review of patients and their clinical records was undertaken in 50 surgical inpatients and repeated in 54 patients following a departmental educational presentation. Outcomes were measured against the WHO analgesic ladder and NICE 147 guideline.
Pain was managed adequately in 30% patients in the first cycle and in 46% the second cycle. Prescribing habits were inadequate in 30% of patient’s vs 16% of patients in the first cycle. Prophylactic laxatives were prescribed in 100% of eligible patients in the second cycle, and anti-emetics were offered to 92% in the first cohort vs 82% in the second. Overall, it can be seen that changeover of staff affects the prescribing habits which should be unique for all surgical inpatients.
Pain management of surgical patients has improved following a departmental intervention. However, measures to address pain and opiate side effects should be continued with involvement of the entire team including nurses, clinicians and pain team practitioners.
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