Post-operative pain management by nurses in an intensive care unit: a best practice implementation project

Author:

Moraes Érica Brandão de12,Antunes Juliane de Macedo3,Ferrari Maria Fernanda Muniz13,Fontes Bárbara Ventura13,Pereira Renata Castro da Silva3,Ogawa Luciana42,Daher Donizete Vago1

Affiliation:

1. Nursing School, Federal Fluminense University, Niteroi, Rio de Janeiro, Brazil

2. The Brazilian Center for Evidence-based Healthcare: A JBI Center of Excellence, São Paulo, Brazil

3. National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil

4. University Hospital, University of São Paulo, São Paulo, Brazil

Abstract

ABSTRACT Introduction: Post-operative pain is the most prevalent type of acute pain. Nurses are the health care professionals who most frequently assess pain, as well as evaluating the patient's response to pain management treatment and monitoring for the occurrence of adverse events. Thus, to improve outcomes and quality of care, the interventions used by nurses should be based on best practices. Objectives: The aim of this project was to implement best practices in post-operative pain management in an intensive care unit. Methods: This evidence implementation project was conducted in a hospital for the surgical treatment of orthopedic diseases and trauma. The project followed the JBI Evidence Implementation Framework. The project used JBI PACES software as well as JBI's Getting Research into Practice (GRiP) audit and feedback tools to develop eight audit criteria for the baseline and follow-up audits. Results: The baseline audit showed that Criteria 3 and 6 had low compliance, with few patients having documented plans and goals, and receiving multimodal analgesia in the ICU, respectively. Criteria 7 and 8, which assessed the use of opioids and follow-up by a pain specialist, revealed compliance of 60% and 50%, respectively. Criterion 3 improved from 0% to 20%. Criteria 6, 7, and 8 also improved, rising to 30%, 22.8%, and 50%, respectively. Conclusion: The project improved compliance with best practices in post-operative pain management. Further studies are needed to ensure the project's long-term sustainability.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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