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Improving pain management after total joint replacement surgery.

J J Neitzel1, E H Miller, M F Shepherd

  • 1Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.

Orthopedic Nursing
|October 29, 2000
PubMed
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Implementing evidence-based pain management strategies improved provider practices and reduced hospital length of stay (LOS) after joint replacement surgery. However, patient-reported outcomes like pain intensity and satisfaction did not significantly improve.

Area of Science:

  • Orthopaedic Surgery
  • Pain Management
  • Healthcare Quality Improvement

Background:

  • Postoperative pain management is crucial for patient recovery and hospital efficiency.
  • Current pain management protocols may not always align with the latest evidence-based practices.
  • Optimizing pain management can impact patient outcomes, provider practices, and healthcare costs.

Purpose of the Study:

  • To evaluate the impact of implementing evidence-based postoperative pain management strategies.
  • To assess effects on patient perceptions, healthcare provider practices, and fiscal outcomes.
  • To determine the effectiveness of a research utilization approach in improving pain care.

Main Methods:

  • A pretest/posttest design was employed with 118 patients undergoing total knee replacement (TKR) or total hip replacement (THR).

Related Experiment Videos

  • Interventions included evidence-based content, provider and patient education, and system changes.
  • Outcomes measured patient pain experience, provider practices, and length of stay (LOS).

    • Main Results:

    • Provider use of meperidine decreased, while hydromorphone use and adherence to pain plans of care increased.
    • Nurse knowledge regarding pain management significantly improved.
    • Length of stay (LOS) was significantly reduced post-implementation.

    Conclusions:

    • Systematic implementation of evidence-based pain management effectively altered provider practices and improved fiscal outcomes.
    • While practice and financial benefits were observed, enhancing patient perception of pain management proved more challenging.
    • The study highlights the potential for research utilization to drive practice change in orthopaedic pain care.