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Changing practice to improve pain control for renal patients
E M Salisbury1, D S Game, I Al-Shakarchi
1Imperial College Kidney and Transplant Institute, Hammersmith Hospital, London, UK. emma.salisbury08@imperial.ac.uk
Postgraduate Medical Journal
|February 26, 2009
Summary
Managing pain in end-stage kidney disease (ESKD) patients is crucial. An adapted World Health Organization (WHO) analgesic ladder significantly reduced pain prevalence and severity in ESKD patients.
Area of Science:
- Nephrology
- Pain Management
- Clinical Audit
Background:
- Pain is a prevalent and often poorly managed symptom in end-stage kidney disease (ESKD) patients.
- Effective pain management strategies tailored to ESKD are lacking.
Purpose of the Study:
- To audit pain prevalence in ESKD inpatients.
- To implement an adapted World Health Organization (WHO) analgesic ladder for ESKD.
- To re-evaluate pain prevalence and severity post-intervention.
Main Methods:
- A cohort study of inpatients on renal wards.
- Pain assessment using a 1-10 severity scale.
- Introduction of interpreters to overcome language barriers.
- Implementation of an adapted WHO three-step analgesic ladder for ESKD.
Main Results:
- A significant reduction in the number of patients reporting pain.
- A significant decrease in the reported severity of pain.
- Effective communication strategies, including interpreters, are vital for patient participation.
Conclusions:
- An adapted WHO analgesic ladder improves pain control in ESKD patients.
- Addressing language barriers is essential for accurate pain assessment and effective management.
- Tailored pain management protocols are necessary for this vulnerable patient population.
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