Document Detail


Process optimization by central control of acute pain therapy : Implementation of standardized treatment concepts and central pain management in hospitals.
MedLine Citation:
PMID:  23135771     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The aim of this investigation was to describe the effects of standardization and central control of the processes involved in postoperative pain management from patient and employee perspectives. MATERIALS AND METHODS: Patients (n = 282/307) and respective hospital staff (n = 149/119) evaluated the processes, the quality of postoperative pain management and result parameters 3 months before and 12 months after the introduction of standardization of the postoperative pain therapy process using a set of standardized questionnaires. RESULTS: Pain level and the waiting period for an analgesic partially decreased and a higher subjective effectiveness of medication was achieved in patients after the standardization. Patients felt that the pain was taken more seriously and contacted the staff for additional medication more frequently. From an employee viewpoint the quality of care and individual competence and ability to treat pain increased after the introduction of standardization. Pain assessment was improved and employees rated their knowledge and education level as higher than before the intervention. Patients with pre-existing chronic pain and patients with special regional therapy benefited only partially after the introduction and an increase in pain intensity was even observed. CONCLUSIONS: The quality of care was improved by standardization of the postoperative pain management. The legal and practical ability of the nursing stuff to administer pain medication within well-defined margins reduced the dependence on the ward doctor and at the same time patient pain levels. Patients received analgesics more quickly and experienced increased effectiveness. These results should be an incentive to reconsider the importance of the organization of postoperative pain management, because the quality of care with all potential medical and economic advantages, can be easily optimized by such simple mechanisms. They also show that the quality assessment of acute pain and the selection of appropriate indicators need further development.
Authors:
J Erlenwein; D Stüder; J-P Lange; M Bauer; F Petzke; M Przemeck
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-9
Journal Detail:
Title:  Der Anaesthesist     Volume:  -     ISSN:  1432-055X     ISO Abbreviation:  Anaesthesist     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370525     Medline TA:  Anaesthesist     Country:  -    
Other Details:
Languages:  GER     Pagination:  -     Citation Subset:  -    
Affiliation:
Geschäftsfeld Schmerzmedizin, Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Universitätsmedizin Göttingen, Robert Koch Str. 40, 37075, Göttingen, Deutschland, joachim.erlenwein@med.uni-goettingen.de.
Vernacular Title:
Prozessoptimierung durch zentrale Steuerung der Akutschmerztherapie : Implementierung von standardisierten Behandlungskonzepten und zentralem Schmerzmanagement im Krankenhaus.
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