Paper
Wednesday, July 21, 2004
The Effects of Implementing a Research-Based Nursing Approach to Pain Management on Pain Intensity Ratings and Patient Satisfaction Ratings in Post-Operative Primary Hip and Knee Arthroplasty Patients
Finola Bell, RGN, RGM, ONC, BNS, MSC, Nursing Administration, Nursing Administration, Cappagh National Orthopaedic Hospital, Dublin, Ireland
| Learning Objective #1: Appreciate the benefits of implementing a research-based nursing approach to pain management in terms of pain intensity outcomes |
| Learning Objective #2: Appreciate the difficulties associated with measuring and interpreting patient satisfaction with their pain management |
Despite major advances in clinical research related to pain management, patients continue to report high post-operative pain intensity ratings. Research findings suggest that institutional efforts to implement and support a research-based approach to pain management, are more likely to result in better pain management, compared to the traditional non research-based approach. The purpose of this study was to investigate the effects of implementing a research-based nursing approach to pain management on pain intensity at rest and with movement, overall satisfaction with results of pain management and satisfaction with nurse responsiveness to pain, in primary elective hip and knee arthroplasty patients. Bhola’s Configuration Model of Planned Change was used to conceptualise the study. A quasi-experimental, after only, non-equivalent control group design and a sample of 67 subjects presenting at a Dublin Orthopaedic Hospital was used. Pain intensity was measured on a visual analogue scale and patient satisfaction on a 6 point Likert scale. Data were analysed using descriptive and inferential statistics. Findings indicate that hip and knee arthroplasty participants whose nurses followed a research-based nursing approach to pain management experienced significantly lower pain intensity at rest and with movement compared to participants whose nurses followed a traditional approach to pain management. However, no significant difference was identified between the satisfaction ratings of the two groups despite the difference in their pain intensity ratings. Additional findings indicated the movement pain intensity ratings of the knee arthroplasty participants as significantly higher than similar ratings of the hip arthroplasty participants. No significant difference was identifies between the resting pain intensity ratings of the hip and knee arthroplasty participants. The results indicate that nurses who use a research-based nursing approach to pain management can improve pain outcomes. The results have particular implications for nurse managers because they have primary responsibility for implementing research-based management strategies.
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Sigma Theta Tau International
July 21, 2004