The quality of our pain management efforts has been one of our quality improvement projects for over two years. As part of the monitoring efforts, self-reported pain experiences are collected via patient interviews one day a month. The interview includes questions on current pain scores, pain scores over the previous 24 hours, and satisfaction with pain management. Approximately six months ago, patients on our cardiac surgery step-down unit began reporting less satisfaction with their pain management, particularly during the immediate recovery period. They will even able to relate the pain to the endotracheal tube rather than their incisions. In further investigating the root cause of these findings, we learned that the routine postoperative pain medication had been changed from Morphine to Fentanyl in an effort to reduce intubation times. In a literature search, only one article could be found that compared these two opioids in a post-operative cardiac sample. This presentation will describe the internal data collection process, the integration of the internal and external evidence in a research proposal, and the process for garnering support of the interdisciplinary cardiac surgical team and staff nurses to further explore this clinical issue with a randomized clinical study.
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Sigma Theta Tau International
9 July 2003