Original Article
Pain Prevalence Study in a Large Canadian Teaching Hospital. Round 2: Lessons Learned?

https://doi.org/10.1016/j.pmn.2009.01.002Get rights and content

Abstract

Pain prevalence is an important indicator of quality patient care, representing a basis upon which improvement efforts may be developed. Based on results of an original pain prevalence survey at our institution in 2006, a follow-up prevalence study was conducted in November 2007. Pain and its interference with patients’ activities, patient satisfaction with pain management efforts, prescribing practice, and perceived barriers to pain control were all studied using a modified version of the American Pain Society Patient Outcomes Questionnaire. Methodologic objectives included improving the response rate from the earlier study and collecting additional demographic data. A 58% response rate was achieved. Pain prevalence at the time of the survey was 84%, and 25.8% of patients experienced severe pain, on average, over the previous 24 hours. Patients were generally quite satisfied with pain management efforts. Of particular interest were the prescribing practices. Only 50% of patients studied on the medical units had a PRN opioid order. These results reinforce those of our original prevalence study, specifically, that pain is not well controlled at our institution.

Section snippets

Study Design

The study was a cross-sectional (prevalence) study of hospitalized patients’ pain experience. The Research Ethics Board renewal was obtained in July 2007, and the study occurred on November 21, 2007.

Methods

Approximately 6 months before the study, investigators approached the director of nursing and outlined the support that would be necessary to improve on the quality of the 2006 study. The investigators requested and received financial support from the corporate nursing budget to pay for supplies

Demographics

Two hundred forty-two patients met the inclusion criteria. Unfortunately, 75 patients were not approached owing to time constraints. Of the 167 patients approached, 98 consented to participate (58.1% response rate; Fig. 1). The mean age of participants was 62.7 years (range 19-88 years), and 52% were female. The mean number of days in the hospital was 8.23 days (range 1-49 days). For patients on surgical units, the mean number of days after surgery was 4.96 (range 0-33 days [0 = awaiting

Discussion

Overall, the 2007 study was deemed to be a success by the investigators. Compared with the 2006 study, the investigators felt more organized during the planning and implementation phases in 2007. Several factors contributed to this: 1) The investigators had an entire year to prepare for the second study; 2) careful notes were taken at a debriefing session after the 2006 study and the “lessons learned” were incorporated; 3) having the extra human resources volunteered by the NC was critical to

Acknowledgments

The authors are grateful for the statistical support and guidance provided by Alex Kiss, biostatistician, and Marko Katic, biostatistician, from the Institute for Clinical Evaluative Sciences. The authors also thank the members of the Nursing Council for their ongoing support of this study.

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