Pain management for discharged patients

Audit In January 2017, an audit was completed with the aim of ascertaining whether there were recurrent concerns from discharged patients.

The Results 25 follow up phone calls were reviewed 18/25 (72%) of phone calls stated there were no concerns 1/25 (4%) of phone calls stated wound concerns 6/25 (24%) of phone calls stated medication concerns

5/6 phone calls involved orthopaedic surgery 1 ankle surgery 1 knee surgery 3 shoulder surgeries The remaining phone call involved ENT Tonsillectomy

Medication concerns discussed were Inadequate analgesia cover Side effect from analgesia eg nausea/vomiting, constipation, wooziness/spaced Lack of understanding of the medications eg what to take when, can they take 2 medications at the same time, how often can they take it

The audit findings indicate there is room for improvement

Any patient requiring multi modal analgesia during their stay at Grace Hospital would benefit from a pain management plan eg patients with chronic pain issues, joint replacement surgery, shoulder surgery, back surgery, mastectomy surgery

At TPH the Pain Management team have standardized pain plans for different types of surgery. However At Grace Hospital we have 57 surgeons and 24 anaesthetists with different approaches to pain management. It would be impossible to standardize a pain plan.

We have developed our own Pain Management plan. Hence We have developed our own Pain Management plan. We have tried to make it simple and concise This is not a prescription – no dosage is written on the form. No transcribing. The focus is on the type of pain relief and how it works – tick/highlight the prescribed medication Guidance is given on how to manage pain Information is given on potential side effects

The key to success A TEAM APPROACH Pain medication discussion, education and ongoing review from each shift nurse. Repetition and positive guidance. Involving whanau/family when discussing home management plan. Education increases the patients awareness and understanding of analgesia and potential side effects. It enables the patient to take responsibility and control with guided support.

Thank you