Evaluación del dolor en pacientes con cáncer de hígado después de una hepatectomía: un proyecto de implementación de...

Patients with liver cancer experience varying degrees of post-operative pain (POP) after hepatic resection, which adversely affects their quality of life, clinical outcomes, and satisfaction. POP assessment, the first step in POP management, is often inadequate.

This project aimed to implement best practices for POP assessment in the General Surgery department of a hospital in China.

Using the JBI Evidence Implementation Framework, we conducted a non-concurrent control study. A baseline audit evaluated adherence to evidence-based practices. Then, a barriers analysis was conducted, and a follow-up audit was performed after the implementation of strategies. Patient outcomes as well as nurses' knowledge and attitudes were also evaluated at baseline and follow-up.

Baseline compliance with best practices was low. However, after implementation, significant improvements were observed: a multidisciplinary team was established; nurse training coverage increased from 40% to 100% ( p  < 0.001); regular rest POP assessment rose from 0% to 66.67% ( p  < 0.001); twice daily POP assessment during activity increased from 0% to 80% ( p  < 0.001); provision of pre-operative pain diary instruction and patient use of pain diary increased from 0% to 70% and 60%, respectively (both p  < 0.001). Patient satisfaction with POP management and education significantly increased ( p  < 0.001), as did patients' pain-related knowledge, attitudes, and behaviors (all p  < 0.001). Nurses' knowledge and attitudes toward POP assessment also improved significantly ( p  < 0.001).

The implementation of multifaceted, evidence-based strategies substantially improved POP assessment practices in patients after hepatectomy, demonstrating the effectiveness of a systematic approach for quality improvement in POP management.