Impact of a pilot team on patients’ pain reduction and satisfaction in an emergency department: A before-and-after observational study

Kone, Victoria; Lecomte, François; Randriamanana, D.; Pourriat, Jean-Louis; Claessens, Yann-Érick; Vidal-Trécan, G.

doi:10.1016/j.respe.2015.11.010

Cited by 9 publications

(8 citation statements)

References 21 publications

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“…Given the geographic coverage provided by the 856 patient charts across seven countries from a large number of hospitals (n=145) and physicians (n=189), this study likely provides a robust picture of analgesic timelines for patients with acute musculoskeletal injuries in real-world practice compared with clinical studies that would typically involve a limited number of centers. Single-center observational studies reporting waiting times in excess of 40 mins in European hospital ED for patients with moderate-to-severe pain support these findings 9,20. Nevertheless, this retrospective study was associated with some limitations.…”

Section: Resultsmentioning

confidence: 53%

<p>Evaluation of pain relief treatment and timelines in emergency care in six European countries and Australia</p>

Xia

Dickerson

Watson

et al. 2019

OAEM

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PurposeInadequate relief of pain is common in prehospital and hospital emergency department (ED) settings. We investigated pain treatments and timelines in patients receiving pre-hospital and hospital ED care to provide insight into potential approaches to reduce the burden of trauma-related pain.Patients and methodsIn this observational, retrospective chart review, patients had received emergency care for musculoskeletal trauma injuries and analgesic treatment for moderate-to-severe pain in Belgium, France, Germany, Italy, Spain or Sweden. As inhaled low-dose methoxyflurane (LDM) is used extensively in Australia but was not widely available in Europe at the time of this analysis, data from Australia were collated to provide insight into the potential utility of this analgesic in Europe. The primary endpoint was time to administration of first pain relief treatment following arrival of paramedic/ED care.ResultsRandomly selected physicians (n=189) collated data from 856 patients (Europe: n=585; Australia: n=271) via an online survey. Time to first pain relief treatment varied between countries and was significantly longer across Europe versus Australia (mean [SD] 38.1 [34.7] vs 29.9 [35.5] mins; P=0.0017). Patients from Australia who received LDM experience a shorter mean (SD) time to first pain treatment following arrival of emergency care versus patients who received other analgesics (propensity score matched [n=85] per group: 21.7 [24.2] vs 39.1 [43.0] mins; P=0.0013). Across all countries, mean (SD) time to first analgesic was shorter when treatment was administered by paramedics versus hospital ED staff (15.7 [14.7] vs 49.1 [38.4] mins).ConclusionsWhile there was a large variation in analgesia timelines across countries, mean times are shorter in Australia compared with Europe overall. In Australia, use of LDM was associated with a significantly shorter time from emergency assistance to first pain treatment compared with non-LDM treatments. Further studies are needed to investigate the utility of LDM in Europe.

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Section: Resultsmentioning

confidence: 53%

<p>Evaluation of pain relief treatment and timelines in emergency care in six European countries and Australia</p>

Xia

Dickerson

Watson

et al. 2019

OAEM

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“…Data from real-world studies included in this literature analysis indicate that many patients with moderate-to-severe trauma pain do not receive analgesia within the 15 to 20-min timeframe suggested in the two local European guidelines identified [ 8 , 19 ]. For example, in a French observational study, 35% of patients waited for more than 60 min before examination, and average waiting times in excess of 40 min were reported in other audits conducted in hospitals in France and Portugal [ 4 , 18 , 59 ]. Similarly, in a prehospital setting, an average of 38 min was reported between paramedic arrival and administration of analgesia in a pan-European audit of patients with emergency trauma pain [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

“…A critical area for improvement in time to analgesia in the ED is in triage time. Patients’ first demonstration of pain in the ED presents an opportunity to provide appropriate analgesia, so a delay in this process presents a barrier to timely pain relief [ 59 ]. Triage systems used in EDs typically include an assessment of patients’ pain to guide analgesia use and prioritize patients for treatment [ 4 , 8 , 20 , 61 ].…”

Section: Resultsmentioning

confidence: 99%

“…Pain imposes a substantial burden on emergency care, as this is often the primary complaint of patients presenting to EDs [ 59 ]. We have identified a variety of limitations associated with many analgesics, including difficulties associated with IV administration necessary for some drugs and bulky equipment requirements for N 2 O, particularly in pre-hospital settings [ 34 , 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Review of the Burden of Trauma Pain in Emergency Settings in Europe

Dissmann

Maignan

Cloves³

et al. 2018

Pain Ther

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Trauma pain represents a large proportion of admissions to emergency departments across Europe. There is currently an unmet need in the treatment of trauma pain extending throughout the patient journey in emergency settings. This review aims to explore these unmet needs and describe barriers to the delivery of effective analgesia for trauma pain in emergency settings. A comprehensive, qualitative review of the literature was conducted using a structured search strategy (Medline, Embase and Evidence Based Medicine Reviews) along with additional Internet-based sources to identify relevant human studies published in the prior 11 years (January 2006–December 2017). From a total of 4325 publications identified, 31 were selected for inclusion based on defined criteria. Numerous barriers to the effective treatment of trauma pain in emergency settings were identified, which may be broadly defined as arising from a lack of effective pain management pan-European and national guidelines, delayed or absent pain assessment, an aversion to opioid analgesia and a delay in the administration of analgesia. Several commonly used analgesics also present limitations in the treatment of trauma pain due to the routes of administration, adverse side effect profiles, pharmacokinetic properties and suitability for use in pre-hospital settings. These combined barriers lead to the inadequate and ineffective treatment of trauma pain for patients. An unmet need therefore exists for novel forms of analgesia, wider spread use of available analgesic agents which overcome some limitations associated with several treatment options, and the development of protocols for pain management which include patient assessment of pain.Funding: Mundipharma International Ltd.Electronic supplementary materialThe online version of this article (10.1007/s40122-018-0101-1) contains supplementary material, which is available to authorized users.

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“…Pacientams gavus tinkamą bei lūkesčius atitinkantį nuskausminimą, t.y. kai skausmo įvertinimo pokytis vizualaus atitikmens skalėje po gydymo yra didesnis ar lygus 2 balams ir mažesnis nei 4 balai, bendras pacientų pasitenkinimas SPS paslaugomis kyla (6,9,10). Pomero F. ir bendraautorių bei Schwartz T. tyrimuose atskleista, jog nesuteikus nuskausminimo, bendras pacientų pasitenkinimas SPS paslaugomis sumažėja (7,11).…”

Section: įVadasunclassified

Skubios Pagalbos Skyriaus Pacientų Pasitenkinimui Reikšmės Turintys Veiksniai

Aniulytė¹,

Verikas²,

Lindžiūtė³

et al. 2018

Public Health

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Sveikatos priežiūros įstaigų pacientų pasitenkinimoteikiamomis paslaugomis rodikliai yra veiksminga jųvertinimo priemonė. Šiems rodikliams didelę įtakądaro personalo bendravimo įgūdžiai ir mandagus elgesyssu pacientu. Tyrimo tikslas yra įvertinti LSMUKauno klinikų Skubios pagalbos skyriaus (SPS) pacientųskausmo malšinimo ir medicinos personalobendravimo su pacientais reikšmę pacientų pasitenkinimuiteikiamomis paslaugomis.Skubios pagalbos skyriaus pacientų momentinėanoniminė anketinė apklausa, tyrimo anketą adaptavuspagal JAV CAHPS ir Jungtinės Karalystės TheFriends and Family test klausimynus. Anketą sudarėdemografiniai ir su paciento vizitu susiję duomenysbei 14 vertinimui skirtų klausimų (pacientų nuomonėvertinta skalėje nuo 1 iki 7 balų). Apklausa vykdyta2016 metų rugsėjo – 2017 metų vasario mėnesiais,tyrime dalyvavo 604 pacientai.SPS darbą geriausiai vertino pacientai, kurių amžiusper 81 metai, balų vidurkis 6,79 (sn±0,413), oblogiausiai - 18 ir 30 metų amžiaus pacientai 6,5(sn±1,019). Nustatytas vidutinio stiprumo ryšys tarpskausmo malšinimo efektyvumo ir pasitenkinimoskubios pagalbos skyriaus darbu (r=0,408; p<0,05).Pacientų pasitenkinimas SPS darbu labiausiai siejosisu gydytojo darbo įvertinimu (r=0,591, p<0,05), oskyriaus pagalbinio personalo (r=0,535) ir slaugytojų(r=0,481) atliekamo darbo vertinimas turėjo mažesnį,tačiau taip pat statistiškai reikšmingą ryšį (p<0,05)su pacientų pasitenkinimu SPS paslaugomis.Šiame tyrime atskleista, kad SPS pacientų pasitenkinimolygis suteiktomis paslaugomis yra aukštas.Skausmo malšinimas siejasi su geriau vertinamomispaslaugomis. Viso personalo darbas yra reikšmingas,tačiau gydytojų darbas yra pagrindinis veiksnys, kurissiejasi su geresniais pacientų pasitenkinimo rodikliais.

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Impact of a pilot team on patients’ pain reduction and satisfaction in an emergency department: A before-and-after observational study

Cited by 9 publications

References 21 publications

<p>Evaluation of pain relief treatment and timelines in emergency care in six European countries and Australia</p>

<p>Evaluation of pain relief treatment and timelines in emergency care in six European countries and Australia</p>

A Review of the Burden of Trauma Pain in Emergency Settings in Europe

Skubios Pagalbos Skyriaus Pacientų Pasitenkinimui Reikšmės Turintys Veiksniai

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