Quality control of postoperative acute pain service

To establish an effective method of continuous quality control of acute pain service, a retrospective study on incident reporting during postoperative analgesia period was conducted. Incidents were reported and analyzed in 1507 patients who received epidural postoperative analgesia, and the results of satisfaction of pain relief was compared with those of incident analysis. In this study, an incident was defined as any factor that might or had affected patient's safety during analgesia period. Our results showed that 1203 incidents were reported in 641 of 1507 patients, of which 122 incidents were critical. 78.3% of all incidents were detected by acute pain service stuff. The most common incidents included complications, insufficient analgesia and problems with delivery circuits. Human factors were involved in 28.9% of the incidents, most being associated with technical failure due to unskillfulness, poor communications between APS stuff and patients and lack of cooperation with surgeons and nurses. The general satisfaction rate of the patients was 90.8%. There was a very significant difference between the satisfaction of the patients who suffered from incidents and who did not (P < 0.001). It is concluded that incidents affect the satisfaction of the patients who received postoperative pain relief. Incident reporting is a more effective method for quality control of acute pain service.