Post-operative acute pain assessment and management in breast cancer patients: a best practice implementation project

Surgery is a common treatment method for breast cancer. After surgery, patients may experience acute pain, which can exacerbate their suffering and negatively affect their post-operative recovery.

This project aimed to enhance the assessment and management of acute pain after breast cancer surgery in a large tertiary hospital in China.

This project followed the seven steps of the JBI Evidence Implementation Framework. Through a baseline audit, the practice gap was identified. The JBI Getting Research into Practice (JBI GRiP) tool was also used to analyze barriers, strategies, and resources. Based on this analysis, the best evidence was translated into a specific implementation plan, which included training nurses in pain assessment and management, providing patient health education, formulating relevant systems and process, incorporating traditional Chinese medicine interventions, and updating the electronic pain assessment form. The project's effectiveness was evaluated by comparing data from the baseline and follow-up audit.

In the baseline audit, except for Criterion 1 which achieved 100%, the other criteria ranged from 0% to 22.5%. The barrier analysis identified insufficient knowledge, lack of pain management process and tools, and the absence of effective non-pharmaceutical measures. After implementing the improvement strategies, a follow-up audit showed that, except for Criterion 13, each criterion exceeded 80%, with four achieving 100%.

This study indicated that by implementing strategies with systematic nurse training, optimization of processes and tools, and traditional Chinese medicine intervention can enhance the quality of post-operative acute pain assessment and management and nurse's compliance with best practices.