Authors (including presenting author) :
Fu WMC(1), Yu YW(1), Wong WL(1), Wong ACF(1), Mok LC(1), Cheng YC(1)
Affiliation :
(1)Orthopaedics and Traumatology Department, Palema Youde Nethersole Eastern Hospital
Introduction :
Post-operative acute pain is the most common adverse event after Orthopaedic surgery. Inadequate pain control can result a series of negative consequences including increased morbidity, decreased patient's well-being, delay recovery and rehabilitation, and increased length of stay in hospital (Gan, 2017). With emerging technologies and increased analgesic options, patients should have greater satisfaction with well-managed post-operative pain. However, studies have shown that patient pain were still undermanaged (Apfelbaum, Chen, Mehta, & Gan, 2003). Patient knowledge deficit of analgesic is the primary reason leading to undermanagement of pain (Timmerman, et al. 2014). Patient empowered with knowledge of analgesic not only increase patient independency, it could also improve pain control (Pate, et al. 2019).
Objectives :
The program was to empower patient with knowledge of post-operative pain, pain assessment and oral analgesic. A set of education kit was designed based on the principle of people-centered care. By using the education kits and nursing interaction, the program aims to improve post-operative pain control.
Methodology :
In July 2021, a patient empowerment program was carried out on selected patients having operation at Orthopaedic and Traumatology (O&T) department in Pamela Youde Nethersole Eastern Hospital. A set of education kit was developed based on literature research and comments from hospital pain team and O&T Nurse Consultant. It consisted of an education apps and pamphlets, allowing patients to revisit the education material by scanning a QR code on demand. The content of the education apps could be chosen by staff based on the medications prescribed to the patient and are tailored to meet the needs of the patient. Afterwards, nursing interaction including discussion with patient about the effect of analgesic, reinforcement on the use of analgesic and ongoing pain assessment were performed. Patients were asked to evaluate their pain level regularly and encouraged to ask for analgesic when needed.
Result & Outcome :
Result
From 5th July 2021 to 26th September 2021, there were 89 patients recruited in the empowerment program. Patients received quiz on pain management to set a baseline of their knowledge before the empowerment program and received a second quiz with same set of questions after attending the empowerment program to evaluate the effectiveness of the knowledge delivery. 80% of the patients (72/89) correctly answer all the questions in the post-quiz as compared to only 38% of the patients (34/89) in the pre-quiz of the program. Besides, patients were asked to fill in an evaluation survey on the empowerment program on the day of discharge. More than 90% of the patients (81/89) agreed that the empowerment program can demystify analgesic, they had learned more about the analgesic that were prescribed to them and helped to lessen their worries about post operation pain management. All patients gave positive feedback to the program and thought that the program is helpful to them.
For staff, although they need extra effort initially to carry out the empowerment program and showing the program details to patients, they had positive feedbacks. As patients learned pain control knowledge from the program, they can perform proper pain assessment, request for analgesic when necessary and seldom reject taking analgesic due to misunderstanding of analgesic, this ended up reducing workload of staff to repeatedly explaining and educating patients about pain control and analgesic.
Discussion and Conclusion
The study found that patients are more willing to use prescribed analgesic when they are equipped with sufficient knowledge. Knowledge delivery and education were found essentials for patients, to empower and motivate them to use analgesic for pain management. Thus, post-operative pain control can be managed by patient proactively and efficiently.
In clinical implication, with better pain management, patients could have less complications, recover faster and be discharged earlier.
The success of the program prompts the workgroup to continue our professional service and benefit more patients. In the coming future, we would like to recruit more patients to our program and include more content in the education apps like non-pharmacological methods in pain control. We believe that without committed staff and teamwork, even a comprehensive tool will not get an ideal result.
