Use of a Validated Reference Tool to Evaluate Postoperative Pain Management through a Quality-Improvement Program in a University Hospital.

Autor: Binhas, Michèle, Roudot-Thoraval, Françoise, Bonnet, Francis, Guerineau, Sabine, Lory, Chantal, Jeanblanc, Grégoire, Kluger, Michael D., Marty, Jean
Zdroj: Journal for Healthcare Quality: Promoting Excellence in Healthcare; Jan2011, Vol. 33 Issue 1, p7-13, 6p
Abstrakt: We audited the seven surgical departments of a university hospital before and after implementation of a program aiming to improve practices in postoperative pain management (POPM). Audits were conducted 2 years apart. During each evaluation, 10 medical charts from each surgical department (i.e., 70 charts) were analyzed for 9 quality criteria (five concerning anesthetist practices and four nursing practices). Two scores were calculated: one per department and the other per criteria. After the first audit, the seven departments received recommendations to improve their POPM. Targeted-training sessions were instituted for the three poorest performing departments (scores <4.5 out of 9 criteria). During the period between the two audits, all seven departments improved their scores; a statistically significant improvement was observed in five departments, including the three that had received targeted-training sessions. Moreover, overall scores for seven of the nine evaluated criteria improved, significantly for three criteria. Anesthetists significantly increased their overall score from 2.5±0.8 to 3.7±0.6 out of 5 points ( p=.018), while surgical nurses' overall score did not change significantly from 2.3±0.7 to 2.9±0.7 out of 4 points ( p=.128). In conclusion, using a standardized and validated instrument to evaluate POPM practices enables the identification of surgical departments requiring practice improvement and those quality criteria requiring reinforcement. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index