Randomized clinical trial to assess the effect of an educational programme designed to improve nurses' assessment and recording of postoperative pain

Author:

Ravaud P1,Keïta H2,Porcher R3,Durand-Stocco C1,Desmonts J M2,Mantz J2

Affiliation:

1. Département d'Epidémiologie et INSERM EMI 0357, Faculté Lariboisière-Saint-Louis (Université Paris 7) et INSERM ERM 0321, Paris, France

2. Département d'Anesthésiologie, Hôpital Bichat-Claude Bernard (Assistance Publique–Hôpitaux de Paris), Faculté Xavier Bichat (Université Paris 7), Faculté Lariboisière-Saint-Louis (Université Paris 7) et INSERM ERM 0321, Paris, France

3. Département de Biostatistique et Informatique Médicale, Hôpital Saint Louis (Assistance Publique–Hôpitaux de Paris), Faculté Lariboisière-Saint-Louis (Université Paris 7) et INSERM ERM 0321, Paris, France

Abstract

Abstract Background The aim of this study was to evaluate the impact of an intervention designed to improve postoperative pain assessment and recording by nurses. Methods This cluster randomized clinical trial included two intervals of 3 months each: a preintervention observational study (period 1) followed by a period of intervention (period 2). Six surgical wards were randomly assigned to receive either an experimental intervention, including educational seminars for nurses on pain, pain assessment and the use of a visual analogue scale (n = 3), or standard care (control group; n = 3). The main outcome measures were the percentage of patients in whom pain was assessed, number of pain assessments per patient and postoperative pain intensity scores. Results A total of 2278 patients were included. Significant improvements were found in the percentage of patients in whom pain was assessed and the number of daily pain assessments per patient in the intervention group between periods 1 and 2. In contrast, these outcomes were unchanged between the two intervals in wards randomized to standard care. During period 2, pain scores at 48 h were significantly decreased in the intervention wards compared with those in the control group. Conclusion An educational programme dedicated to nurses strongly increased the use of regular pain assessment, and may have contributed to a modest improvement in postoperative analgesia.

Funder

Assistance Publique-Hôpitaux de Paris

Institut Electricité Santé

Publisher

Oxford University Press (OUP)

Subject

Surgery

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