Patient controlled analgesia--a pharmacy based service.

Area of Science:

• Pharmacology
• Pain Management
• Health Services Research

Background:

• Patient-controlled analgesia (PCA) is an established method for managing pain using programmable infusion devices.
• A dedicated pain management service was established in the authors' hospital in 1989.
• Pharmacists have historically been involved in PCA for postoperative pain relief.

Purpose of the Study:

• To describe the integration and operational model of a hospital-based pain management service.
• To highlight the expanded role of pharmacists in managing patient-controlled analgesia therapy.
• To document the pharmacy department's involvement in a new pain management service.

Main Methods:

• Physician orders for PCA therapy are processed through the pharmacy computer system.
• The central intravenous (IV) admixture service prepares drugs and programs PCA pumps.
• Staff pharmacists provide direct support to nurses and patients, including pump initiation, patient training, and ongoing management.

Main Results:

• The pharmacy department assumed comprehensive responsibility for PCA pump procurement, storage, drug preparation, and programming.
• Staff pharmacists are integral to initiating PCA therapy, educating patients, and managing all subsequent programming adjustments and problem resolution.
• Pharmacists undergo periodic certification in programming skills as part of quality assurance.

Conclusions:

• The pharmacy department's active participation is crucial for the successful operation of the pain management service.
• Pharmacist involvement in PCA ensures quality control, patient safety, and efficient pain management.
• Over 1800 patients benefited from this innovative PCA service in 1990, demonstrating its impact.