Evaluation of 5 years of postoperative pain management in orthopaedic surgery, in a private hospital, following quality standard management

Objective. - To report the 5 years' experience of a postoperative pain service according to quality standards management. Material and methods. - The goals of pain treatment were determined from the description of the initial inquiries performed in 1994. Decrease in the postoperative pain for all the patients operated at the first and the third postoperative day, systematic evaluation of the pain, implementation of common therapeutic protocols, information and satisfaction of the patients, improvement in side effects' management, and a bearable managing cost. The deadline of these objectives was 1999. Patients were followed-up by a questionnaire at the third postoperative day, by verbal scale scoring every 4 h, by reporting techniques and analgesic drugs, and side effects. An audit of the nurses, was performed through a questionnaire in 1999. Results. - Four thousand sixty-eight patients were included in the audit over 5 years (1995-1999). Twelve objectives out of 15 were reached. Painful patients were less numerous, said themselves less painful, were more quickly relieved, and were satisfied by their management. The incidence of side effects was much lower than the figures of the literature. Conclusion. - Pain control on mobilization, maintenance of a high quality continuous formation, and development of pain control process in the other surgical departments are the new goals in progress. (C) 2003 Editions scientifiques et medicales Elsevier SAS. All rights reserved.