Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
Lau KY(1), YeungKP(2), Yip YK(1)
Affiliation :
(1)Surgery Ward, Princess Margaret Hospital, (2)Urodynamics & Endourology Centre, Princess Margaret Hospital
Introduction :
The pain assessment guideline in the Department of Surgery, Princess Margaret Hospital had instructed staff to use Numeric Rating Scale (NRS) to reassess pain, but the timing of pain reassessment is not clearly indicated.
Random sampling of 10 surgical ward patients were interviewed regarding the satisfaction of pain assessment during hospitalization. Although 70% of patients indicated that Q8H pain assessment was enough, there was less review on the effectiveness of drugs and reassessment of pain as reported by 80% of interviewees.
An insufficient assessment could cause underestimation of the patient’s pain which contributes to inadequate pain control. Thus, it leads to a higher readmission rate, longer length of hospitalization and poor patient satisfaction rate. Therefore, a clear instruction on timing and frequency of pain reassessment were encouraged.
Objectives :
(1)to investigate the frequency and timing of pain reassessment following analgesic given in surgical patients; (2)to explore the components of pain assessment for a communicable patient.
Methodology :
Literature review among multiple academic databases done on (1) evidence-based guidelines regarding frequency and timing of pain reassessment following analgesic given in hospital, and (2) the components of pain assessment that should be included for a communicable patient with Keywords such as “pain reassessment”, “pain assessment”, “assessment tool” and “pain frequency”.
Result & Outcome :
A total of 4 literature were identified regarding frequency and timing of pain reassessment following analgesic given in hospital. Reassessment of pain was recommended within 30 minutes or within 60 minutes after giving analgesic. Furthermore, a total of 4 evidence-based guidelines were identified that the reassessment of pain was suggested within 15 minutes to 1 hour after giving analgesic, according to medication route.
For the components of pain assessment, a total of 8 literatures were included. Studies suggested the NRS was only a unidirectional assessment. A multidimensional pain assessment, including location, nature, aggravating or alleviating factors, was recommended. Thus, a more comprehensive pain assessment is required.
The result of the literature review facilitated the creation of a cue card for colleagues to reassess pain within 30-60 minutes after analgesic given , and remind components of pain assessment according to current pain assessment guidelines. Also, Pain assessment form or guidelines for surgical ward is needed to be updated with emphasizing the frequency and timing of reassessment on pain.
