Standardized pain flowsheet: impact on patient-reported pain experiences after cardiovascular surgery

Abstract

BACKGROUND: Administration of analgesics per patient request or random pain assessments may provide inadequate pain management. OBJECTIVE: To examine the impact of nurses' use of a standardized pain flowsheet to document pain assessment and pharmacologic management on patient-reported pain intensity. METHODS: A pre-post intervention design was used to compare 61 patients. In the preimplementation group, traditional charting of pain presence or absence was documented in the narrative notes and pharmacologic management was recorded on the medication profile. In the postimplementation group, the intensity of pain and pharmacologic management were documented on a pain flowsheet. Within 24 hours after transfer to the step-down unit, patients were interviewed regarding pain intensity experienced in the surgical heart unit and at the time of questioning. The distribution of these pain intensity scores was compared. RESULTS: The postimplementation group reported significantly lower pain intensity ratings for the average amount of pain experienced while in the surgical heart unit, the least amount of pain experienced while in the surgical heart unit, and the pain experienced at the moment of questioning. CONCLUSIONS: Use of a standardized pain flowsheet to assess pain intensity and document pharmacologic intervention may improve pain management in postsurgical cardiovascular patients.