Acute pain assessments and records: a pilot study of digital transformation
Pain is a leading cause of disability worldwide. Pain assessments are an essential part of evidence-based care and management. Among comparable care providers, there is variation in how nurses document assessments as well as the content in them, and there is a notable associated administrative burden.
This study evaluated the impact and significance of a new, structured, digitised pain assessment form from quality, safety and efficiency standpoints.
Samples of pain assessments were examined at three consecutive stages: first, the pre-existing form was used, then the new structured form was introduced and, finally, the structured form was taken away and nurses went back to completing the original form. Assessments were scored by two clinical analysts against 18 clinically defined pain-related characteristics and factors. The time taken to extract and interpret the assessments was also recorded. Statistically significant changes were assessed using Welch's t-tests and Fisher's exact tests.
There was a significant improvement in data quality using the new structured form compared with the pre-existing template, including an increase in the capture of five safety-related variables. Less time was needed to extract and interpret data with the new form.
Intelligent structured forms are highly effective for documenting pain assessments, and offer notable benefits in quality, safety, and efficiency.
Pain is an almost universally experienced phenomenon (Wall et al, 2006). As a physiological sensation, it serves to protect an organism from harm and limit damage. The influence of psychological factors on the perception of pain is well recognised (Darnall et al, 2016). Acute post-surgical pain can persist well beyond 3 months (Richebé et al, 2018). This chronic post-surgical pain can affect up to one in 10 surgical patients (Glare et al, 2019), with one in 100 experiencing intolerable pain (Fletcher et al, 2015).
While there are many risk factors for developing chronic post-surgical pain including mood, pre-existing pain and the use of pre-operative analgesia, the trajectory of the acute pain course in the days following surgery as well as the amount of time spent in severe pain seem to be important factors (Lavand'homme, 2017). This provides an opportunity for careful in-hospital monitor ing, which could potentially impact outcomes.
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