Refusing analgesics: using continuous improvement to improve pain management on a surgical ward

Area of Science:

• Healthcare Quality Improvement
• Pain Management in Hospitals
• Surgical Patient Care

Background:

• Many hospitalized patients experience moderate to severe pain due to inadequate pain assessment and misconceptions.
• A preliminary audit on a surgical ward revealed ineffective control of postoperative pain.

Purpose of the Study:

• To reduce the number of patients refusing analgesics offered by nurses.
• To improve postoperative pain management and quality of care using a continuous improvement framework.

Main Methods:

• Utilized the 'Model for Improvement' framework for problem analysis and change implementation.
• Introduced a patient information sheet, regular documented pain assessments, and staff education.
• Conducted pre- and post-intervention audits to assess changes in analgesic acceptance rates.

Main Results:

• Initial audit: 70% (93/133) of patients refused analgesics.
• Post-intervention audit: 44% (63/167) of patients accepted analgesics, a statistically significant decrease (P = 0.005).

Conclusions:

• Continuous improvement methodology effectively enhances pain management and patient care quality.
• This patient-centered approach offers realistic, achievable, and sustainable solutions for healthcare settings.
• Motivating staff and patients through ownership and meaningful change is possible even with resource constraints.