The Effect of a Triage Pain Management Protocol for Patients With Minor Musculoskeletal Injury in an Accident and Emergency Department (A & E) in Hong Kong

2.50
Hdl Handle:
http://hdl.handle.net/10755/152537
Type:
Presentation
Title:
The Effect of a Triage Pain Management Protocol for Patients With Minor Musculoskeletal Injury in an Accident and Emergency Department (A & E) in Hong Kong
Abstract:
The Effect of a Triage Pain Management Protocol for Patients With Minor Musculoskeletal Injury in an Accident and Emergency Department (A & E) in Hong Kong
Conference Sponsor:Sigma Theta Tau International
Conference Year:2005
Author:Wong, Eliza Mi-Ling, MSN
P.I. Institution Name:The Chinese University of Hong Kong
Title:Professional consultant
The study objectives were (1) evaluated the effect of introducing a new triage pain protocol on pain assessment and pain management for patients presenting to an emergency department with minor musculoskeletal injury, and (2) determined the analgesic efficacy, safety, and time to initial analgesia of using oral paracetamol at triage. The primary outcomes were pain assessment, time to prescribe analgesia and reduction in pain. Methods In phase 1 (S1) baseline data (pre-test) was collected and a triage pain protocol was developed. In phase 2 (S2) a pain protocol was introduced and its effect was assessed. Two hundred and ninety-six patients aged 18years and who presented with minor musculoskeletal injury of an isolated single limb participated in this study: 97 patients in the S1 period and 199 patients in the S2 period. Interventions included (1) a triage pain protocol with pain assessment; (2) permission for the triage nurse to prescribe Paracetamol (panadol) at triage. Result: There was an increase in the rate of nurse assessment of pain between the S1 and S2 phases (19% v 81%; p<0.0001). During S2, the time to initial analgesia was shorter in the triage paracetamol group compared with patients who waited for a doctor to prescribe analgesia (9 minutes Vs 93 minutes, P<0.005). The mean reduction in VAS after 60 minutes in the ED was 21mm in the nurse initiated Paracetamol group compared with 0.7 mm in those patients who did not receive analgesia at triage but rather waited for doctor initiated analgesia (Z =-3.251, P=0.001). No adverse effects of Paracetamol treatment were reported by participants. Introducing a nurse triage pain protocol and empowering nurses to prescribe analgesia for patients with minor musculoskeletal injury at triage resulted in an increased rate in pain assessment, earlier prescription of analgesia and an earlier reduction in pain score.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Effect of a Triage Pain Management Protocol for Patients With Minor Musculoskeletal Injury in an Accident and Emergency Department (A & E) in Hong Kongen_GB
dc.identifier.urihttp://hdl.handle.net/10755/152537-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Effect of a Triage Pain Management Protocol for Patients With Minor Musculoskeletal Injury in an Accident and Emergency Department (A &amp; E) in Hong Kong</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Wong, Eliza Mi-Ling, MSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The Chinese University of Hong Kong</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professional consultant</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">elizawong@cuhk.edu.hk</td></tr><tr><td colspan="2" class="item-abstract">The study objectives were (1) evaluated the effect of introducing a new triage pain protocol on pain assessment and pain management for patients presenting to an emergency department with minor musculoskeletal injury, and (2) determined the analgesic efficacy, safety, and time to initial analgesia of using oral paracetamol at triage. The primary outcomes were pain assessment, time to prescribe analgesia and reduction in pain. Methods In phase 1 (S1) baseline data (pre-test) was collected and a triage pain protocol was developed. In phase 2 (S2) a pain protocol was introduced and its effect was assessed. Two hundred and ninety-six patients aged 18years and who presented with minor musculoskeletal injury of an isolated single limb participated in this study: 97 patients in the S1 period and 199 patients in the S2 period. Interventions included (1) a triage pain protocol with pain assessment; (2) permission for the triage nurse to prescribe Paracetamol (panadol) at triage. Result: There was an increase in the rate of nurse assessment of pain between the S1 and S2 phases (19% v 81%; p&lt;0.0001). During S2, the time to initial analgesia was shorter in the triage paracetamol group compared with patients who waited for a doctor to prescribe analgesia (9 minutes Vs 93 minutes, P&lt;0.005). The mean reduction in VAS after 60 minutes in the ED was 21mm in the nurse initiated Paracetamol group compared with 0.7 mm in those patients who did not receive analgesia at triage but rather waited for doctor initiated analgesia (Z =-3.251, P=0.001). No adverse effects of Paracetamol treatment were reported by participants. Introducing a nurse triage pain protocol and empowering nurses to prescribe analgesia for patients with minor musculoskeletal injury at triage resulted in an increased rate in pain assessment, earlier prescription of analgesia and an earlier reduction in pain score.</td></tr></table>en_GB
dc.date.available2011-10-26T11:39:59Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T11:39:59Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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