1 / 17

Pain Management

Pain Management. Patient Controlled Oral Analgesia at Home (PCOAH) Dr Jeremy D Stevens Consultant Anaesthetist Wairau Hospital Blenheim. Introduction. AUDIT CYCLE (revision) Problem identified Audit of current practice & literature review Analyse & discuss need for change

tanuja
Télécharger la présentation

Pain Management

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Pain Management

  2. Patient Controlled Oral Analgesia at Home (PCOAH) Dr Jeremy D Stevens Consultant Anaesthetist Wairau Hospital Blenheim

  3. Introduction • AUDIT CYCLE (revision) • Problem identified • Audit of current practice & literature review • Analyse & discuss need for change • Institute change of practice • Re-audit & review • Repeat as necessary • The project/audit – ‘Pain and Emesis experiences at home after day surgery for 48 hours’ (UK) • Poster • Publication • PHO web-site

  4. The UK Project • Problems highlighted – early 1996 * • Multidisciplinary approach * • Audit of current practice – late 1996 • Standardised questionnaire (article) • Literature review – international • No standards • Change of practice – early 1997 • Re-audit – late 1997 • Presentations – 1998 • Publications – 1999

  5. UK – Change of Practice • Simplify / standardise • Evidence based / balanced analgesia • Pack design 1 & 2 • Information and self administration leaflet • Decision: ‘Which pack type?’ (NSAID sensitivity) • Prescribing simplified: Pack 1 or 2 • Administration by day care nurses prior to discharge • ‘Free’ to the patient; part of contract for the operation • 5 day supply

  6. NZ Project (so far) • Same issues raised – late 2007 • UK tool applied for audit – 2008/2009 • Multidisciplinary team working model

  7. RESULTS

  8. WAIRAU DAY SURGERY AUDIT – PATIENT EXPERIENCES AT HOMERESPONSE & SAMPLE CHARACTERISTICS

  9. WAIRAU DAY SURGERY AUDIT – PATIENT EXPERIENCES AT HOMEPATIENTS IN MODERATE OR SEVERE PAIN

  10. WAIRAU DAY SURGERY AUDIT – PATIENT EXPERIENCES AT HOMEANALGESIC CONSUMPTION & EFFECTIVENESS (1)

  11. WAIRAU DAY SURGERY AUDIT – PATIENT EXPERIENCES AT HOMEANALGESIC CONSUMPTION & EFFECTIVENESS (2)

  12. WAIRAU DAY SURGERY AUDIT – PATIENT EXPERIENCES AT HOMEANALGESIC EFFECTIVENESS

  13. WAIRAU DAY SURGERY AUDIT – PATIENT EXPERIENCES AT HOMEPATIENT OUTCOMES (1)

  14. WAIRAU DAY SURGERY AUDIT – PATIENT EXPERIENCES AT HOMEPATIENT OUTCOMES (2)

  15. WAIRAU DAY SURGERY AUDIT – PATIENT EXPERIENCES AT HOMEPATIENT SATISFACTION(NZ Audit Only)

  16. Results Summary • Better response • Older ages • Less moderate – severe pain – Consultant service? • Less analgesics supplied • Initial operation day less taken • Less total relief on first day post-op • More sleep disturbance second day post-op • Intermediate information supplied • Overall more contact post-op > 30% pain • Good contact details supplied/functional • Good patient satisfaction

  17. Questions • Is change warranted? Is there a problem? • If change in practice – what? • Similar to UK model? • NZ design? • Multidisciplinary approach? – DEFINITELY • COLLABORATIVE FEEDBACK REQUIRED • Contact - jeremy.stevens@nmdhb.govt.nz

More Related