Tracey Bucknall1, Elizabeth Manias, Mari Botti. 1. School of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Level 1, 723 Swanston Street, Carlton, Victoria, Australia 3053. bucknall@unimelb.edu.au
Abstract
OBJECTIVES: To identify when and how nurses reassess patients' pain after analgesic administration in the postoperative context. METHODS: Fifty-two nurses were observed caring for postoperative patients (N=364) in 2 surgical settings in a major metropolitan hospital. Seventy-four observation periods of 2 hours duration were studied. The research assistant observed nurses' activities in caring for the allocated patients', detailing behavioral and verbal responses onto audiotape. RESULTS: Of the 316 pain activities that occurred in 74 observation periods, 14 (4.4%) were reassessments after analgesic administration. Four themes were evident from the 14 reassessments: opportunistic reassessment, the use of simple questioning, a focus on surgical wound pain not procedural pain, and nurse-initiated reassessment. CONCLUSIONS: Despite the focus on meeting standards of care in the area of pain management, there was an extraordinary lack of patient reassessment by nurses after the administration of analgesics. Given the raised awareness internationally on assessment generally and a lack of evidence focused on reassessment after an intervention, this may explain why research is failing to identify shifts in pain severity scores and indeed patient pain.
OBJECTIVES: To identify when and how nurses reassess patients' pain after analgesic administration in the postoperative context. METHODS: Fifty-two nurses were observed caring for postoperative patients (N=364) in 2 surgical settings in a major metropolitan hospital. Seventy-four observation periods of 2 hours duration were studied. The research assistant observed nurses' activities in caring for the allocated patients', detailing behavioral and verbal responses onto audiotape. RESULTS: Of the 316 pain activities that occurred in 74 observation periods, 14 (4.4%) were reassessments after analgesic administration. Four themes were evident from the 14 reassessments: opportunistic reassessment, the use of simple questioning, a focus on surgical wound pain not procedural pain, and nurse-initiated reassessment. CONCLUSIONS: Despite the focus on meeting standards of care in the area of pain management, there was an extraordinary lack of patient reassessment by nurses after the administration of analgesics. Given the raised awareness internationally on assessment generally and a lack of evidence focused on reassessment after an intervention, this may explain why research is failing to identify shifts in pain severity scores and indeed patientpain.