1. Pain management for discharged patients

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

3. 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

4. 5/6 phone calls involved orthopaedic surgery
1 ankle surgery
1 knee surgery
3 shoulder surgeries
The remaining phone call involved ENT
Tonsillectomy

5. 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

6. The audit findings indicate there is room for improvement

7. 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

8. 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.

9. 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

12. 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.

13. Thank you