Improving Pain Management for Patients on Patient-Controlled Analgesia (PCA)

2.50
Hdl Handle:
http://hdl.handle.net/10755/165589
Category:
Abstract
Type:
Presentation
Title:
Improving Pain Management for Patients on Patient-Controlled Analgesia (PCA)
Author(s):
Fogarty, Elizabeth
Author Details:
Elizabeth Fogarty, University of Texas, M.D. Anderson Cancer Center, Houston, Texas, USA
Abstract:
While reviewing information on patient satisfaction and outcomes in our inpatient gastrointestinal surgery unit, we found that only 75% of our patients were satisfied with their PCA pain control. We decided to improve our patient pain management by decreasing idleness and pulmonary complications and improve mobility and inhalation. We applied the M.D. Anderson quality-improvement process called Plan, Do, Check, Act. The first step was gathering the right people. We traced the steps of the patient through the gastrointestinal clinic, pre-op clinic, post anesthesia care unit, surgical intensive care unit, and gastrointestinal intestinal in-patient unit and added representatives from each of those areas to our team. We also added an anesthesiologist, nursing instructor, patient educator, and quality-improvement representative for advice and guidance. The team then held a brainstorming session, developed a cause-and-effect fishbone diagram, and determined that the problem was caused by patient and staff education deficits. Our goals were to provide consistent education about PCA of patients in all areas of the institution, identify the key elements of patient PCA education, and create interventions to correct the problem. Thirty patients were surveyed for deficits in baseline knowledge. We developed a PCA Guideline Sheet (also known as A.I.R.S.-assessment, intervention, reassessment, and side effects) and on-line educational materials compatible with the guidelines. We incorporated the PCA guidelines into our nursing pain-assessment and management standards and formulated and launched a lesson plan for educating staff. Then, using the two-step back process (looking two cycles backwards in the process) we determined that education of patients on PCA pumps needed to start in the clinic. After patient education materials were used and the staff was educated, we resurveyed the patients for improvement. Patient satisfaction with pain control increased from 75% to 90%. Because of the high success rate, we chose to incorporate these methods and guidelines into nursing practice within our entire institution. While the outcome and procedures would prove to be helpful to any patient care institution, the process of plan, do, check, act could be used to custom fit any institution's particular needs.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
27th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Washington, D.C., USA
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.titleImproving Pain Management for Patients on Patient-Controlled Analgesia (PCA)en_GB
dc.contributor.authorFogarty, Elizabethen_US
dc.author.detailsElizabeth Fogarty, University of Texas, M.D. Anderson Cancer Center, Houston, Texas, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/165589-
dc.description.abstractWhile reviewing information on patient satisfaction and outcomes in our inpatient gastrointestinal surgery unit, we found that only 75% of our patients were satisfied with their PCA pain control. We decided to improve our patient pain management by decreasing idleness and pulmonary complications and improve mobility and inhalation. We applied the M.D. Anderson quality-improvement process called Plan, Do, Check, Act. The first step was gathering the right people. We traced the steps of the patient through the gastrointestinal clinic, pre-op clinic, post anesthesia care unit, surgical intensive care unit, and gastrointestinal intestinal in-patient unit and added representatives from each of those areas to our team. We also added an anesthesiologist, nursing instructor, patient educator, and quality-improvement representative for advice and guidance. The team then held a brainstorming session, developed a cause-and-effect fishbone diagram, and determined that the problem was caused by patient and staff education deficits. Our goals were to provide consistent education about PCA of patients in all areas of the institution, identify the key elements of patient PCA education, and create interventions to correct the problem. Thirty patients were surveyed for deficits in baseline knowledge. We developed a PCA Guideline Sheet (also known as A.I.R.S.-assessment, intervention, reassessment, and side effects) and on-line educational materials compatible with the guidelines. We incorporated the PCA guidelines into our nursing pain-assessment and management standards and formulated and launched a lesson plan for educating staff. Then, using the two-step back process (looking two cycles backwards in the process) we determined that education of patients on PCA pumps needed to start in the clinic. After patient education materials were used and the staff was educated, we resurveyed the patients for improvement. Patient satisfaction with pain control increased from 75% to 90%. Because of the high success rate, we chose to incorporate these methods and guidelines into nursing practice within our entire institution. While the outcome and procedures would prove to be helpful to any patient care institution, the process of plan, do, check, act could be used to custom fit any institution's particular needs.en_GB
dc.date.available2011-10-27T12:21:24Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:21:24Z-
dc.conference.date2002en_US
dc.conference.name27th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationWashington, D.C., USAen_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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