Analgesia in the orthopedic emergency department (Master thesis)

Γεωργαράκου, Κυριακή

Pain is a multidimensional phenomenon, which is the main reason for which patients visit Emergency Departments (ED). Although medical science has developed to a significant extent, pain is not adequately managed in ED, mainly because doctors and nurses are not well trained to have adequate knowledge and skills, working conditions in ED are very difficult, analgesia protocols are not followed and health professionals underestimate patients’ pain. Aims-Objectives: The aim of the research was to identify whether education and analgesia protocol can help in increasing the effectiveness of pain management in ED. Method: In the first research phase, pain intensity was assessed for 100 randomly-chosen patients, who visited the ED of a well-known public hospital in Athens, Greece. After analgesia, their pain intensity was once again measured. After that, 50 randomly chosen doctors and nurses of the hospital were asked to assess the adequacy of analgesia provided to patients. Following the above, health professionals of the ED were subject to education intervention and applied a specific analgesia protocol for 2 months. Then, a new sample of 100 randomly-chosen patients followed the same process as patients in the first phase, while the same 50 health professionals were asked once again to assess the adequacy of analgesia. Results: Analgesia was given to 57% of patients in the first phase, while this percentage statistically significantly increased to 71% after training and analgesia protocol application. These interventions helped in increasing the use of opioids for analgesia, but waiting time in the ED and intensity of pain were not significantly reduced. The number of health professionals characterizing analgesia as adequate was increased as a result of the interventions, but also not statistically significantly. Difficult working conditions and underestimation of initial pain remained the most important factors that could lead to oligoanalgesia. Conclusion: Training and the application of analgesia protocol increase the effectiveness of pain management in ED, but there are other factors to also consider, whose impacts on pain management are more statistically significant. Training should be more focused on improving health professionals’ skills in estimating initial pain and on further decreasing opiophobia, while working conditions at ED need to improve.
Alternative title / Subtitle: μελέτη της υιοθέτησης πρωτοκόλλου αναλγησίας μετά από εκπαιδευτική παρέμβαση
an examination on the impact of training and analgesia protocols the effectiveness of pain management
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Subject classification: Αναλγησία
Keywords: Οξύς πόνος,Ορθοπαιδικό Τμήμα Επειγόντων Περιστατικών,Πρωτόκολλο αναλγησία,Εκπαίδευση,Orthopaedic emergency departments,Pain protoco / analgesia,Training,Αcute pain
Appears in Collections:Διατριβές Μεταπτυχιακής Έρευνας (Masters)

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