Perioperative factors associated with Hospital Consumer Assessment of Healthcare Providers and Systems responses of total hip arthroplasty patients
| Autor: | Pauline Woo, Charles Louy, Waylan Wong, Dermot P. Maher, Roya Yumul, Xiao Zhang |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Quality Assurance Health Care Arthroplasty Replacement Hip Health Personnel Midazolam Perioperative Care Pacu 03 medical and health sciences 0302 clinical medicine Patient satisfaction Surveys and Questionnaires Medicine Humans Pain Management Anesthesia 030212 general & internal medicine Arthroplasty Replacement Knee Aged Pain Measurement Retrospective Studies Pain Postoperative biology business.industry Trauma center Anti-Inflammatory Agents Non-Steroidal Age Factors Perioperative Middle Aged biology.organism_classification Hospitals Analgesics Opioid Anesthesiology and Pain Medicine Opioid Patient Satisfaction Cohort Physical therapy Female business Healthcare providers 030217 neurology & neurosurgery Anesthetics Intravenous medicine.drug |
| Zdroj: | Journal of clinical anesthesia. 34 |
| ISSN: | 1873-4529 |
| Popis: | Objective To determine perioperative treatments and events associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) responses among patients who undergo total hip arthroplasties (THAs) and total knee arthroplasties (TKAs). Design Retrospective analysis. Setting Single tertiary care, academic, urban, level 1 trauma center. Participants Final cohort represents 301 consecutive surgical inpatients meeting criteria for evaluation by HCAHPS survey. Exposures Responses to 4 HCAHPS questions were analyzed against perioperative treatments and events. Measures Positive and negative responses to HCAHPS questions. Results THA patients responding affirmatively to both pain specific and general satisfaction were associated with preoperative use of chronic nonsteroidal anti-inflammatory drugs. In addition, THA patients responding affirmatively "how often was your pain well controlled" were also associated decreased postanesthesia care unit (PACU) opioid requirement. TKA patients responding affirmatively to "what number would you use to rate this hospital" were associated with shorter PACU stays and lower final pain scores. TKA patients responding affirmatively to "would you recommend this hospital to your family" were associated with shorter lengths of stay in the hospital and in the PACU. TKA patients responding affirmatively to "How often did the hospital staff do everything to help with your pain" were not associated with any measured perioperative event. TKA patients responding affirmatively to "how often was your pain well controlled" were associated with older age, decreased use of preoperative chronic benzodiazepines, and increased use of preoperative midazolam. Conclusions These data suggest that chronic use of nonsteroidal anti-inflammatory drugs is associated with improved overall satisfaction and satisfaction with pain in THA patients. Furthermore, increased PACU opioid use was negatively associated satisfaction with pain management. Age, lengths of stay preadmission medications, anxiolytic medications, and PACU pain scores are associated with patient satisfaction with regards to both pain management and overall satisfaction in TKA patients. |
| Databáze: | OpenAIRE |
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