2012-03-01
Pain management after cardiac surgery: Experience with a nurse-driven pain protocol
Publication
Publication
European Journal of Cardiovascular Nursing , Volume 11 - Issue 1 p. 62- 69
Objective: Management of post-operative pain is important for decreasing post-operative morbidity and mortality. After evaluating our pain score database of patients undergoing cardiac surgery (2007-2009) we revised our pain protocol. The new protocol allows nurses to administer analgesic medication without consulting the attending physician. The setting was a medium care unit, a nursing ward with additional monitoring of heart rate and rhythm. We investigated the effects of this revised pain protocol in a prospective consecutive cohort study. Methods: We evaluated 193 patients treated according to the revised protocol (RP group) during the first 72 hours post-cardiac surgery on the medium care unit. A visual analogue scale (VAS) was used as pain scoring system. These patients were compared with a control group (Ctrl group) consisting of 1535 patients. Results: Patients from the RP group had a mean VAS of 2.2 compared to a mean VAS of 2.8 in the Ctrl group (p < 0.0001). In the Ctrl group 44% of patients with a VAS ≥ 4 maintained this score for 8 hours afterwards. In contrast, in the RP group 81% had a reduction in VAS score within 3 hours. Using the new protocol there were no adverse events requiring intervention such as medication or readmission to an intensive care unit. Conclusions: This study shows that in post-cardiac surgery patients a significant reduction in VAS scores can be safely realized by a nurse-driven protocol. Furthermore, a reduction in time to achieve an acceptable pain score (VAS < 4) was realized.
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doi.org/10.1177/1474515111430879, hdl.handle.net/1765/69554 | |
European Journal of Cardiovascular Nursing | |
Organisation | Department of Cardio-Thoracic Surgery |
van Valen, R., van Vuuren, H., van Domburg, R., van der Woerd, D., Hofland, J., & Bogers, A. (2012). Pain management after cardiac surgery: Experience with a nurse-driven pain protocol. In European Journal of Cardiovascular Nursing (Vol. 11, pp. 62–69). doi:10.1177/1474515111430879 |