In postoperative patients (P), does the implementation of a multimodal pain management approach (I), compared to traditional unimodal pain management (C), resulting in improved pain control, reduced opioid consumption, and shorter hospital stays (O) within the first 72 hours after surgery (T)?
Inadequate Pain Management in Postoperative Patients
Introduction
An important part of patient care is postoperative pain management, which aims to reduce pain and discomfort after surgical procedures. However, ineffective pain management continues to be a problem, which could impact patients’ well-being, healing, and medical outcomes. For surgical patients, postoperative discomfort is a frequent and upsetting experience. Long-term suffering, a slower rate of recovery, lower patient satisfaction, and higher medical costs can all result from insufficient pain treatment (Parthipan et al., 2019). The use of opioids, which run the risk of side effects such as respiratory depression, constipation, and opioid dependence, is a common component of traditional unimodal pain management strategies.
The inadequate handling of postoperative pain has been addressed by numerous research. A comprehensive analysis shows that up to 86% of surgical patients feel moderate to severe pain during the postoperative phase (Cureus, 2020). Poor pain management has been linked to a greater incidence of surgical complications, higher healthcare expenses, longer hospital stays, and lower patient satisfaction. This paper recommends using a multimodal pain treatment strategy for postoperative patients within the first 72 hours following surgery. We intend to enhance pain management, lower opioid consumption, and decrease hospital stays by using a multimodal strategy.
PICOT
In postoperative patients (P), does the implementation of a multimodal pain management approach (I), compared to traditional unimodal pain management (C), resulting in improved pain control, reduced opioid consumption, and shorter hospital stays (O) within the first 72 hours after surgery (T)?
Population: Postoperative patients within the first 72 hours after surgery. Intervention: Implementation of a multimodal pain management approach. Comparison: Traditional unimodal pain management. Outcome: Improved pain control, reduced opioid consumption, and shorter hospital stays. Timing: Within the first 72 hours after surgery.
Vulnerable Population
The vulnerable population in the context of insufficient postoperative pain treatment comprises those who may be at higher risk due to numerous variables such as age, comorbidities, restricted access to healthcare resources, and socioeconomic disadvantages (Cureus, 2020). Their overall health outcomes and capacity to get proper pain care can be greatly impacted by socioeconomic determinants of health, such as income, education, and social support.
Risk Factors Contributing to Vulnerability
Advanced age: Older patients may experience changed pain perception and diminished physiological reserves, necessitating specialized pain management techniques.
Comorbidities: Patients needing tailored pain management plans may have increased pain sensitivity due to chronic illnesses like diabetes or cardiovascular disease.
Limited access to healthcare facilities: Vulnerable groups may struggle to receive effective postoperative pain treatment due to a lack of healthcare services, particularly specialized pain clinics or drug resources (Parthipan et al., 2019).
Socioeconomic disadvantages: People with lower socioeconomic levels may encounter difficulties accessing healthcare services due to problems with transportation, limited resources, or a lack of health insurance.
Evidence-based Interventions
They were using multimodal pain treatment techniques: putting into practice a mix of medical and non-medical therapies suited to each patient’s requirements. Non-opioid analgesics, procedures for regional anesthesia, patient-controlled analgesia, and complementary therapies like physical therapy, acupuncture, or breathing exercises may all be used in this situation (Afshan et al., 2021).
Providing patients with thorough preoperative and postoperative education about pain expectations, pain management techniques, and the significance of adhering to drug regimens would improve patient education (Parthipan et al., 2019). The availability of alternative pain management techniques and the potential hazards and advantages of opioid use should be covered in this instruction.
Facilitating communication and cooperation among medical professionals, such as surgeons, anesthesiologists, nurses, and pharmacists, to ensure a comprehensive approach to pain treatment (Parthipan et al., 2019). Regular pain evaluations, specific treatment regimens, and interdisciplinary talks about pain management are required.
Proposal
Implementing a comprehensive multimodal pain management program is the proposed evidence-based strategy to address the chosen health problem of insufficient pain management in postoperative patients (Parthipan et al., 2019). This initiative will deploy the interventions above, multimodal pain management techniques, improved patient education, inter-professional collaboration, pain management protocols, and technology integration.
Resources Necessary for Intervention
Patient education resources and educational materials.
Drugs for the treatment of pain with various modalities.
Resources for complementary therapy and regional anesthetic procedures.
Platforms or software for analyzing and tracking pain.
Individuals Involved in the Intervention
For perioperative planning and coordination, use surgeons and anesthesiologists.
Nurses with knowledge of pain management for assessment, instruction, and application of pain management procedures.
Pharmacists are responsible for overseeing and managing medications.
Providers of complementary and alternative therapies for physical therapy.
Patients and their families take an active role in pain management.
Feasibility of a Nurse in an Advanced Role:
Nurses in advanced roles, such as nurse practitioners or clinical nurse specialists, hold the knowledge and abilities required to guide and facilitate the implementation of the suggested multimodal pain management program. Their comprehensive training enables them to establish individualized treatment programs, effectively assess and manage postoperative pain, inform patients and their families, work with interdisciplinary healthcare providers, and keep track of patient results (Afshan et al., 2021). Comprehensive pain evaluations, including patient preferences and comorbidities in treatment plans, prescribing and revising suitable analgesics, and coordinating the implementation of non-pharmacological therapies are all skills that these advanced practice nurses possess. Their knowledge includes educating patients about methods for managing pain, possible pharmaceutical side effects, and the significance of following a treatment plan.
Timeline for the proposed intervention:
The allocated time for the intervention is 12 months, where each month is allocated a given task. The first month is allocated for a critical literature search in intervening a success. The protocol is developed in the second month, and stakeholders collaborate in the third month. The implement a multimodal pain management program is done within 6-12 months.
Theoretical Framework
The Health Belief Model (HBM) is the project’s theoretical foundation. A popular nursing theory called the Health Belief Model focuses on people’s perceptions and beliefs about actions that are related to their health. It emphasizes how perceptions of susceptibility, severity, benefits, and obstacles might affect a person’s decision-making and behavior change regarding their health (Parthipan et al., 2019). The Health Belief Model can direct the intervention when there is insufficient pain control in postoperative patients by tackling patients’ attitudes and beliefs about pain control. Healthcare providers can design interventions that boost patients’ perceived advantages when utilizing multimodal management of pain approaches and decrease perceived barriers, such as fear of side effects or lack of knowledge, by assessing patients’ perceived susceptibility to inadequate pain control and the seriousness of the potential consequences (Afshan et al., 2021). The Health Belief Model can help identify the elements affecting patients’ adherence to pain management techniques and aid healthcare professionals in creating educational interventions focusing on particular beliefs and perceptions.
References
Afshan, G., Khan, R. I., Ahmed, A., et al. (2021). Postoperative pain management modalities employed in clinical trials for adult patients in LMIC; a systematic review. BMC Anesthesiology, 21, 160. https://doi.org/10.1186/s12871-021-01375-w
Cureus. (2020, January). Knowledge about postoperative pain and its management in surgical patients. Cureus, 12(1), e6685. https://doi.org/10.7759/cureus.6685
Parthipan, A., Banerjee, I., Humphreys, K., Asch, S. M., Curtin, C., Carroll, I., & Hernandez-Boussard, T. (2019). Predicting inadequate postoperative pain management in depressed patients: A machine learning approach. PLoS ONE, 14(2), e0210575. https://doi.org/10.1371/journal.pone.0210575
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