The Acute Pain Service (APS), a multi-disciplinary team responsible for acute
postoperative pain management, has been a recent development in hospitals. The
purpose of this study was to increase our understanding regarding the effectiveness of
APSs, to evaluate the impact of the implementation of an APS on pain management
within an acute care hospital, and to make recommendations for the improvement of the
APS under study.
A program evaluative method guided the study design that consisted of three
phases. The objective of the first phase was to describe the implementation of the APS.
Interviews and a document review provided data that was then analyzed to identify the
forces and challenges that shaped three eras in the historical development of the service.
The objective of the second phase was to assess the nursing and medical staff satisfaction
with the APS through surveys and interviews. Analysis of the data revealed that while
the staff was generally satisfied with the program, there were several areas identified for
improvement. The objective of the third phase was to assess the impact of the APS on
the control of acute pain. A retrospective chart review comparing two groups of
abdominal surgery patients using patient-controlled analgesia failed to show any
significant difference between acute pain outcomes before and after the implementation
of the service.
The development of an APS, and its ultimate effectiveness, is dependent upon a
number of resources: education, clinical support and adequate communication structures.
Control issues surrounding pain management may arise as a result of the implementation
of an APS. Immediate recommendations for this program included increasing the
visibility of the APS, decreasing the workload associated with the APS modalities,
establishing an effective communication network and increasing clinical support to the
program. Recommendations for future improvement included strengthening
collaboration with the surgeons, promoting more efficient bed utilization by expanding
the epidural local anesthesia program and repeating the program evaluation once changes
are implemented. Several areas for further research surrounding acute pain outcomes and
patient-controlled analgesia were identified. / Applied Science, Faculty of / Nursing, School of / Graduate
| Identifer | oai:union.ndltd.org:UBC/oai:circle.library.ubc.ca:2429/5973 |
| Date | 05 1900 |
| Creators | Pesut, Barbara Kay |
| Source Sets | University of British Columbia |
| Language | English |
| Detected Language | English |
| Type | Text, Thesis/Dissertation |
| Format | 5269137 bytes, application/pdf |
| Rights | For non-commercial purposes only, such as research, private study and education. Additional conditions apply, see Terms of Use https://open.library.ubc.ca/terms_of_use. |
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