Benchmarking as a tool of continuous quality improvement in postoperative pain management

Meißner, Winfried; Ullrich, K.; Zwacka, S.

doi:10.1017/s026502150500205x

Cited by 62 publications

(49 citation statements)

References 27 publications

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“…The standard deviation (SD) of postoperative pain scores following outpatient surgery was 2.4, 14 and the incidence of postoperative nausea and vomiting (PONV) ranged from 20-30%. 15 Based on this information and to detect a minimum difference of one point in pain score and a 15% incidence rate, the sample size was calculated as 160 per group with an alpha = 0.025 and power = 0.80.…”

Section: Sample Size Calculationmentioning

confidence: 99%

Surgical safety checklist: implementation in an ambulatory surgical facility

Morgan

Cunningham

Mitra

et al. 2013

Can J Anesth/J Can Anesth

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Purpose In 2007, the World Health Organization created a Surgical Safety Checklist (SSC) that encompassed a simple set of surgical safety standards. The threefold purpose of this study was to add ambulatory-specific items to the SSC, to introduce the items into an ambulatory surgical facility, and to determine if patient outcomes regarding postoperative pain and nausea/vomiting improved following implementation. In addition, safety attitudes, antibiotic timing, regional anesthesia/nerve blocks, preemptive pain medications, prophylactic antiemetics, length of stay, and hospital admission were also assessed.Methods After Research Ethics Board approval, staff complete a Safety Attitudes Questionnaire. Seven items were added to the SSC. Data were then collected on 180 surgical cases before SSC implementation and 195 cases following implementation. Compliance with each section of the SSC was assessed. Results On postoperative day one, the median (97.5% confidence interval [CI]) difference between pre-and postimplementation pain scores was 0.5 (97.5% CI, 0 to 1; P = 0.13), and the median difference in the rate of postdischarge nausea/vomiting was -8.4% (97.5% CI, -17.9 to 1.1; P = 0.06). There was no improvement in safety attitudes or any of the secondary outcomes, with the exception of the use of preemptive pain medications. Compliance with the three sections of the checklist, i.e., BRIEFING, TIME OUT, and DEBRIEFING was 99.49%, 97.95%, and 96.92%, respectively. There was low compliance in verbalization of the added ''ambulatory-specific items''. Conclusion Potential reasons for lack of uptake and integration include poor ''user'' buy-in, an overly lengthy checklist, and lack of prioritization of ambulatory-specific items. A shortened SSC was developed based on the results of this study. This trial was registered at ClinicalTrials.gov ID: NCT00934310.Author contributions Pamela J. Morgan was involved in the acquisition of funding for this study. Pamela J. Morgan Lisa Cunningham, Wei Wu, Victoria Noguera, and John Semple were involved in the conception and design of the study. Lisa Cunningham, Sohini Mitra, Natalie Wong, and Mary Li were involved in the acquisition of data for the study. Pamela J. Morgan was involved in the interpretation of the data. Pamela J. Morgan, Wei Wu, and Mary Li analyzed the data. Pamela J. Morgan, Lisa Cunningham, and Mary Li were involved in drafting the article. Sohini Mitra, Natalie Wong, Wei Wu, Victoria Noguera, and John Semple were involved in the critical revision of the article. Résumé Objectif En 2007, l'Organisation mondiale de la Sante´a cre´e´une Liste de contrôle de la se´curite´chirurgicale (LCSC) couvrant un ensemble simple de normes de se´curite´pour la chirurgie. L'objectif triple de cette e´tude e´tait d'ajouter des e´le´ments spe´cifiques au contexte ambulatoire a`la LCSC, d'introduire ces e´le´ments dans un centre de chirurgie ambulatoire, et de de´terminer si les devenirs des patients en matie`re de douleur et de nause´es et vomissements postope´ratoires e´taien...

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Section: Sample Size Calculationmentioning

confidence: 99%

Surgical safety checklist: implementation in an ambulatory surgical facility

Morgan

Cunningham

Mitra

et al. 2013

Can J Anesth/J Can Anesth

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“…This includes feedback and benchmarking about patient reported outcomes (PROs) and succinct summaries of evidence-based literature on management of acute pain (= 'Electronic Knowledge Library' (www.pain-out.eu). The project is modelled on the successful German postoperative pain registry, QUIPS (Meissner et al, 2006(Meissner et al, , 2008. PAIN OUT includes data from patients undergoing all types of surgery, it is not restricted to those undergoing major surgery and followed by Acute Pain Services (Pöpping et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

PAIN OUT: The making of an international acute pain registry

Zaslansky

Rothaug

Chapman

et al. 2014

European Journal of Pain

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“…Our study differs from others, which looked at patient satisfaction and adverse events [25,26,27]. Vila et al[ 28] compared patient satisfaction and respiratory events before and after monitoring the fifth vital sign.…”

Section: Discussionmentioning

confidence: 82%

Documenting Pain as the Fifth Vital Sign: A Feasibility Study in an Oncology Ward in Sarawak, Malaysia

Devi¹,

Tang²

2008

Oncology

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Background: Monitoring acute postoperative pain as the fifth vital sign is currently practiced in many developed countries. In Sarawak, pain is an important symptom as 70% of cancer patients present with advanced disease. As the existing validated pain assessment tools were found to be difficult to use, we studied the feasibility of modifying the use of a pain assessment tool, consisting of the short form of the Brief Pain Inventory and the Wong-Baker Faces Scale. Method: This tool was used to document pain in all 169 patients who were admitted for pain control to the oncology ward between July 2000 and June 2001. Nurses were trained in the use of the modified scale before the start of the study. Results: The method was easy to use, and the mean number of days to reduce pain was found to be 3.1 days (SD: 2.9; median: 2 days; range: 1–31 days). At discharge, none in the group with initially mild pain had pain, and the severity of pain for 98% of patients with moderate pain and 61% with severe pain was downgraded to mild pain. Conclusion: The staff found that the tool allowed continuous pain assessment in an objective manner.

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Benchmarking as a tool of continuous quality improvement in postoperative pain management

Cited by 62 publications

References 27 publications

Surgical safety checklist: implementation in an ambulatory surgical facility

Surgical safety checklist: implementation in an ambulatory surgical facility

PAIN OUT: The making of an international acute pain registry

Documenting Pain as the Fifth Vital Sign: A Feasibility Study in an Oncology Ward in Sarawak, Malaysia

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