Pain Score Recording as the Fifth Vital Sign Experience at Orthopedic Surgical Wards, Srinagarind Hospital

ABSTRACT

Background:  Nursing care in the orthopedic surgical wards have in place a policy for quality improvement, which is emphasized by use of pain score recording.Objective:  To audit pain score records for the first 72 hours after surgeryDesign:  Descriptive study with retrospective data collectionSetting:  Orthopedic Surgical Wards at Srinagarind Hospital, Khon Kaen University, ThailandMethods:  Between March and April 2005, we extracted data from the Graphic Sheets for patients ³ 10 years of age.Outcome Measures:  1) All records were audited and the values for pain scores recorded each day including the operative day (Day 0 – assessed by a nurse every 4 hours) and two days post-op (Days 1 and 2 – assessed every 8 hours). Good quality records had regularly recorded pain scores. An improvement in quality was acknowledged if the proportion of quality records was ³80%.  2) The percentage of patients having two-consecutive severe pain recordings (i.e. score ³ 7) on each Day.  3) Mean pain score each time.  4) Patient-satisfaction before discharge.Results:  A total of 94 patients were included.  On Day 0, 98% of the assessment and recording of pain scores occurred, on Day 1 it was 95% and on Day 2 it was 89%. The highest post-operative pain was 5.5 ± 2.5, 4.0 ± 2.5 and 3.1 ± 2.7 on Day 0, 1 and 2; while the lowest pain score was 4.2 ± 2.8, 2.9 ± 2.7 and 2.1 ± 2.1 on Day 0, 1 and 2, respectively.  Percentages of the patients having two-consecutive severe pain were 19%, 5% and 1%, respectively. All of the patients were satisfied with the pain relief offered.Conclusion:  Completion of the assessment and pain score records at the orthopedic surgical wards were high and all of the patients indicated that they were satisfied with the pain service.Keywords  Audit Recording, Orthopedic Wards, Pain Scores, Postoperative