Pain Management Following Surgery: Medication Trends and Documentation in NursesÆ Progress Notes

2.50
Hdl Handle:
http://hdl.handle.net/10755/163543
Category:
Abstract
Type:
Presentation
Title:
Pain Management Following Surgery: Medication Trends and Documentation in NursesÆ Progress Notes
Author(s):
Manias, Elizabeth
Author Details:
Elizabeth Manias, RN, MPharm, MNursStud, PhD, Associate Professor, The University of Melbourne, School of Nursing, Carlton, Victoria, Australia, email: emanias@unimelb.edu.au
Abstract:
Purpose: Providing adequate pain relief to postoperative patients is a difficult goal. Patients receive a number of different medications, through varying routes of administration and various prescribing regimes. Sedatives also have a synergistic effect in alleviating pain. The specific aims of this study was to examine prescribing and administering activities relating to sedative and analgesic medication for postoperative patients in the acute care context, and determine how nurses documented these activities in progress notes. Methods: Patients admitted in two surgical wards of a public, teaching hospital were targeted. A prospective sample of 100 patients was consecutively selected from eligible individuals undergoing gastrointestinal or renal surgery. Data were collected from medication order charts on the day of the operation and for four days following the procedure. Information was gathered about a variety of analgesic and sedative medications, including infusions (epidural and intravenous), patient controlled analgesia (PCAs - epidural and intravenous), fixed order medications and PRN (as required) medications. Nurses' progress note entries (n=1,300) for these patients were also examined prospectively over the same time period. Results: Almost all patients received some form of infusion while the use of PRN analgesics varied from one-third to over two-thirds of patients during the postoperative period. Few patients were prescribed fixed order analgesics or sedative medications. Interestingly, the mean percentage administered by epidural or intravenous infusion decreased to less than 90% by the fourth postoperative day while the mean amount administered by an epidural or by an intravenous PCA remained in excess of 100% by the fourth postoperative day. Nurses had documented inadequately in four major areas: pain assessment, use of non-pharmacological interventions, use of pharmacological interventions, and outcome of interventions. Conclusions and Implications: Balancing patients' needs for managing pain in the postoperative period requires keen clinical judgement that is individualised to particular analgesic needs.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
17th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
New York, New York, USA
Description:
�Translational Research for Quality Health Outcomes: Affecting Practice and Healthcare Policy�, held on April 7th -9th at the Roosevelt Hotel, New York
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePain Management Following Surgery: Medication Trends and Documentation in NursesÆ Progress Notesen_GB
dc.contributor.authorManias, Elizabethen_US
dc.author.detailsElizabeth Manias, RN, MPharm, MNursStud, PhD, Associate Professor, The University of Melbourne, School of Nursing, Carlton, Victoria, Australia, email: emanias@unimelb.edu.auen_US
dc.identifier.urihttp://hdl.handle.net/10755/163543-
dc.description.abstractPurpose: Providing adequate pain relief to postoperative patients is a difficult goal. Patients receive a number of different medications, through varying routes of administration and various prescribing regimes. Sedatives also have a synergistic effect in alleviating pain. The specific aims of this study was to examine prescribing and administering activities relating to sedative and analgesic medication for postoperative patients in the acute care context, and determine how nurses documented these activities in progress notes. Methods: Patients admitted in two surgical wards of a public, teaching hospital were targeted. A prospective sample of 100 patients was consecutively selected from eligible individuals undergoing gastrointestinal or renal surgery. Data were collected from medication order charts on the day of the operation and for four days following the procedure. Information was gathered about a variety of analgesic and sedative medications, including infusions (epidural and intravenous), patient controlled analgesia (PCAs - epidural and intravenous), fixed order medications and PRN (as required) medications. Nurses' progress note entries (n=1,300) for these patients were also examined prospectively over the same time period. Results: Almost all patients received some form of infusion while the use of PRN analgesics varied from one-third to over two-thirds of patients during the postoperative period. Few patients were prescribed fixed order analgesics or sedative medications. Interestingly, the mean percentage administered by epidural or intravenous infusion decreased to less than 90% by the fourth postoperative day while the mean amount administered by an epidural or by an intravenous PCA remained in excess of 100% by the fourth postoperative day. Nurses had documented inadequately in four major areas: pain assessment, use of non-pharmacological interventions, use of pharmacological interventions, and outcome of interventions. Conclusions and Implications: Balancing patients' needs for managing pain in the postoperative period requires keen clinical judgement that is individualised to particular analgesic needs.en_GB
dc.date.available2011-10-27T11:09:22Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:09:22Z-
dc.conference.date2005en_US
dc.conference.name17th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationNew York, New York, USAen_US
dc.description�Translational Research for Quality Health Outcomes: Affecting Practice and Healthcare Policy�, held on April 7th -9th at the Roosevelt Hotel, New Yorken_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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