Abstract
Pain management is essential for quality care in all inpatient settings, where pain may stem from trauma, acute medical conditions, or surgery. Patients with cancer or chronic pain often experience acute exacerbations or may develop acute pain related problems.
This audit aimed to assess adherence to best practices in pain management for hospitalized patients and compare current pain management services in UK.
We conducted an 8-week audit at Derriford Hospital, Plymouth, using patient records from seeEHR. We assessed the effectiveness, safety, and immediacy of pain relief actions and whether patients with complex pain were referred to the Integrated Pain Service (IPS). We also examined if discharge summaries detailed the analgesia provided. Additionally, we surveyed medical staff (doctors and nurses) on their pain management knowledge.
The audit included 50 patients: 32 (64%) from geriatric wards, 10 (20%) from oncology, and 8 (16%) from haematology wards. Patients on at least step 2 of the pain ladder were included. Results showed that analgesia was 74% effective and 26% ineffective. Analgesia was 100% safe, with no antidote used. Immediate action was taken in 96% of cases and a delayed action in 4% cases.
However, none of the discharge summaries (0/50) mentioned pain relief provided, and no patients (0/50) were referred to IPS. The medical staff survey revealed that 50% were unsure when to refer to pain teams. All doctors knew the pain ladder.
The audit indicates timely, effective, and safe pain relief but highlights the need for improved referral practices to IPS for complex pain and detailed analgesia records in discharge summaries. Educating staff on hospital pain management protocols is crucial.
This project is significant for all healthcare professionals and enhances patient care quality. Recommendations were made after the first cycle, and data collection for the second cycle is ongoing.