Quality Improvement Activity for Improving Pain Management in Acute Extremity Injuries in the Emergency Department

Overview

Journal Clin Exp Emerg Med

Specialty Emergency Medicine

Date 2018 Apr 6

PMID 29618194

Citations 2

Authors

Hyung Lan Chang

Jin Hee Jung

Young Ho Kwak

Do Kyun Kim

Jin Hee Lee

Jae Yun Jung

Hyuksool Kwon

So Hyun Paek

Joong Wan Park

Jonghwan Shin

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to investigate the effectiveness of a quality improvement activity for pain management in patients with extremity injury in the emergency department (ED).

Methods: This was a retrospective interventional study. The patient group consisted of those at least 19 years of age who visited the ED and were diagnosed with International Classification of Diseases codes S40-S99 (extremity injuries). The quality improvement activity consisted of three measures: a survey regarding activities, education, and the triage nurse's pain assessment, including change of pain documentation on electronic medical records. The intervention was conducted from January to April in 2014 and outcome was compared between May and August in 2013 and 2014. The primary outcome was the rate of analgesic prescription, and the secondary outcome was the time to analgesic prescription.

Results: A total of 1,739 patients were included, and 20.3% of 867 patients in the pre-intervention period, and 28.8% of 872 patients in the post-intervention period received analgesics (P< 0.001). The prescription rate of analgesics for moderate-to-severe injuries was 36.4% in 2013 and 44.5% in 2014 (P=0.026). The time to analgesics prescription was 116.6 minutes (standard deviation 225.6) in 2013 and 64 minutes (standard deviation 75.5) in 2014 for all extremity injuries. The pain scoring increased from 1.4% to 51.6%.

Conclusion: ED-based quality improvement activities including education and change of pain score documentation can improve the rate of analgesic prescription and time to prescription for patients with extremity injury in the ED.

Citing Articles

Improving door-to-analgesia timing in musculoskeletal injuries in an academic emergency department in India: a quality improvement project.

Sadasivam S A, Kumaran A, Ayyan S, Sindujaa S BMJ Open Qual. 2024; 13(2).

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Prevalence and management of pain in dogs in the emergency service of a veterinary teaching hospital.

Rousseau-Blass F, OToole E, Marcoux J, Pang D Can Vet J. 2020; 61(3):294-300.

PMID: 32165754 PMC: 7020628.

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