Benditz, Achim and Greimel, Felix and Auer, Patrick and Zeman, Florian and Goettermann, Antje and Grifka, Joachim and Meissner, Winfried and von Kunow, Frederik (2016) Can consistent benchmarking within a standardized pain management concept decrease postoperative pain after total hip arthroplasty? A prospective cohort study including 367 patients. JOURNAL OF PAIN RESEARCH, 9. pp. 1205-1213. ISSN 1178-7090,
Full text not available from this repository. (Request a copy)Abstract
Background: The number of total hip replacement surgeries has steadily increased over recent years. Reduction in postoperative pain increases patient satisfaction and enables better mobilization. Thus, pain management needs to be continuously improved. Problems are often caused not only by medical issues but also by organization and hospital structure. The present study shows how the quality of pain management can be increased by implementing a standardized pain concept and simple, consistent, benchmarking. Methods: All patients included in the study had undergone total hip arthroplasty (THA). Outcome parameters were analyzed 24 hours after surgery by means of the questionnaires from the German-wide project "Quality Improvement in Postoperative Pain Management" (QUIPS). A pain nurse interviewed patients and continuously assessed outcome quality parameters. A multidisciplinary team of anesthetists, orthopedic surgeons, and nurses implemented a regular procedure of data analysis and internal benchmarking. The health care team was informed of any results, and suggested improvements. Every staff member involved in pain management participated in educational lessons, and a special pain nurse was trained in each ward. Results: From 2014 to 2015, 367 patients were included. The mean maximal pain score 24 hours after surgery was 4.0 (+/- 3.0) on an 11-point numeric rating scale, and patient satisfaction was 9.0 (+/- 1.2). Over time, the maximum pain score decreased (mean 3.0, +/- 2.0), whereas patient satisfaction significantly increased (mean 9.8, +/- 0.4; p<0.05). Among 49 anonymized hospitals, our clinic stayed on first rank in terms of lowest maximum pain and patient satisfaction over the period. Conclusion: Results were already acceptable at the beginning of benchmarking a standardized pain management concept. But regular benchmarking, implementation of feedback mechanisms, and staff education made the pain management concept even more successful. Multidisciplinary teamwork and flexibility in adapting processes seem to be highly important for successful pain management.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | QUALITY IMPROVEMENT; POSTSURGICAL PAIN; PERCEPTIONS; ANALGESIA; KNOWLEDGE; THERAPY; postoperative pain; total hip arthroplasty; pain management concept; benchmarking |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Orthopädie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 20 Mar 2019 08:51 |
| Last Modified: | 20 Mar 2019 08:51 |
| URI: | https://pred.uni-regensburg.de/id/eprint/2610 |
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