ABSTRACT
Abstract: Keywords: Quality indicators, Pain management, Pain assessment, Measurementoutcome, Patient satisfactionThis article presents an evaluation of quality of pain management bothprocess and outcome in post operative patients at Ramathibodi Hospital by the PainManagement Committee. The Pain Management Committee has been establishedsince B.E. 2546. They are responsible for setting the pain management systemincluding developing work instruction and pain quality indicators. The objective ofthis descriptive study was to evaluate quality of pain management using both processand outcome indicators in postoperative patients admitted to Ramathibodi Hospital.One hundred and sixty nine patients from 11 wards were recruited in the study. Theinstruments used in this study were 1) the Demographic Questionnaire, 2) the PainManagement Process Indicators, and 3) the Pain Management Outcome Indicators.Data analysis was performed using descriptive statistics. The result of this studyshowed that most nurses used the numerical rating pain scale and pain document,which met the goal of pain management process. However, they did not continueassessing pain. In addition, most of the patients received pain medication managementonly when needed rather than around-the-clock. Regarding non-pharmacologicalmanagement, positioning was most used by these patients. For outcome indicators,mean scores of worst pain, and disturbance of functional activity and sleep were inthe moderate level. Of the total sample, 13.6% did not receive information about sideeffect of analgesics, but their satisfaction levels with pain management were good andvery good. Recommendations from this study are that nurses should pay more attention on thecontinuity of pain assessment and management, as well as develop the non-pharmacologicalpain management program combined with analgesics to alleviate pain. These mayresult in decreasing pain intensity, and disturbance of functional activity and sleep.
ABSTRACT
Abstract\ \ Keywords\ \ : Clinical nursing practice guidelines, Breast cancer surgery, Evidencebasedstrategies: The objective of this article was to present the development of clinicalnursing practice guidelines (CNPGs) for patients undergoing breast cancer surgeryby using evidence-based strategies. Thirty-three staff nurses of seven surgical wardsat Ramathibodi Hospital were asked to read, use, and evaluate the CNPGs. Findingsrevealed that two-thirds of the staff nurses reported that the language use, contents,applicability, and usefulness of the CNPGs are good. In addition, the CNPGs werehelpful to strengthen nurses๛ confidence in nursing practice. However, the CNPGshad some limitations and made it not feasible for some cases. Because the CNPGshave been newly developed, it needs more time for nurses to understand themthoroughly.