Postoperative pain: strategy for improving patient experiences

Many patients continue to suffer moderate pain following surgery. Much of this may be unnecessary and could be alleviated with careful strategic pain management. It appears that the knowledge and attitudes of both health care professionals and patients are pivotal to patients' pain experiences.

This paper reports the introduction and evaluation of a nurse-led intervention to improve pain management after surgery.

The study design was experimental (pretest-post-test), comparing patients' pain scores in a control and an intervention hospital over time. The control hospital was included to assess if temporal effects reduced pain scores during the study period. A convenience patient sample was used, and patients' pain scores were measured in two phases (n = 800). Baseline data were compared with subsequent data collected after the introduction of the nurse-led intervention. The intervention included education for nurses in the form of short pain courses, introduction of regular pain assessment and profiling of pain at hospital level.

Introduction of the nurse-led intervention reduced patients' pain scores. This reduction, in the order of 0.73 cm (7.3%) on a visual analogue scale (0-10 cm), was statistically significant for day of surgery and 2 days postsurgery (P < 0.05) in the intervention hospital. A reduction was not seen in the control hospital.

Improvements in pain management can be made by embracing basic pain management principles.