The Impact of Technology on the Analgesic Gap and Quality of Acute Pain Management

Abstract

National surveys continue to document the undertreatment of acute postoperative pain, despite the availability of evidence-based, clinical practice guidelines and the Joint Commission on Accreditation of Healthcare Organizations standards. This article surveys factors that contribute to persistent gaps during the acute pain management process, including deficiencies in providing continuous analgesia, disparities in access to medical care, the acute pain medicine culture itself, a lack of adequate pain assessment, health care provider biases, and limited health care resources. The role of technology in increasing patients' control over their own pain management and narrowing these gaps is discussed. Patient-controlled analgesia delivery systems are an example of such technology, and they play a key role in improving the quality of acute pain management and increasing the patient's involvement in this process. However, the use of these systems may be limited because of the amount of health care resources necessary for their administration and limitations in payment for professional services. Therefore, there exists a need for additional technologies that will simplify the pain management process and reduce the amount of health care resources necessary to provide patients with quality acute pain management.

Postoperative pain management – the influence of surgical ward nurses

“…2000), the nurses in this study underestimated severe pain and overestimated mild pain. Discrepancies between patients’ reports and caregivers’ perception of pain, as well as infrequent monitoring and recording of pain severity, may leave clinicians unaware as to whether a particular treatment is effective or not (Carr et al. 2005).…”

“…Improving the quality of postoperative pain management is a multifactor issue rather than being a matter of plain monitoring of nursing activities. There is a need for improvement in nurse‐physician collaboration, with common goals and sharing of relevant knowledge, to ensure that patients receive the appropriate and optimal care (Carr et al. 2005).…”

An Integrative Review of the Literature on Pain Management Barriers: Implications for the Canadian Clinical Context

“…Nurses play a key role in effective pain management (Ferrell, 2005;RNAO, 2007) and factors influencing effective pain man-agement among health professionals are well documented (Brown, 2004;Prkachin, Solomon, & Ross, 2007;Sun et al, 2007). However, despite decades of extensive research, ineffective pain management continues to be ubiquitous in health care in Canada and in a number of other countries, such as the United Kingdom (Maier et al, 2010;Wadensten, Fröjd, Swenne, Gordh, & Gunningberg, 2011) and the United States (Carr, Reines, Schaffer, Polomano, & Lande, 2005).…”

Cancer Pain: An Age-Based Analysis

“…Globally, both cancer and pain are significant public health problems that are increasing in prevalence [1–5]. Despite national efforts such as the Joint Commission on Accreditation of Hospitals and Healthcare Organizations and the Agency for Healthcare Research and Quality, and despite global efforts such as the World Health Organization and the International Association for the Study of Pain designed to improve both cancer and pain care, nearly 70% of people dying from cancer experience unrelieved pain [6–9]. Cancer pain, such as pain associated with cancer or its treatment, exacts a significant individual and societal toll and is increasing, especially among those with advanced cancer [10–17].…”