Journal review
Blank FS, Mader TJ, Wolfe J, et al. Adequacy of pain assessment and pain relief and correlation of patient satisfaction in 68 ED fast-track patients. J Emerg Nurs 2001; 27:327-334.
Acute pain is underevaluated and undertreated in the fast-track setting, says this study from Baystate Medical Center in Springfield, MA. A total of 68 patients with minor nonemergent pain were surveyed upon arrival and again before discharge. Patients rated their pain with a Visual Analog Scale and also gave pain ratings they were willing to accept before leaving the ED. Here are key findings:
• Almost all patients (93%) were willing to go home with a certain amount of pain.
• Of these patients, 60% went home with more pain than they were willing to accept.
• Half of the patients were given pain medication, and only half of those patients said the pain relief was adequate.
• The median time from arrival to administration of pain medication was one hour and 44 minutes.
• The median patient satisfaction rating for overall care was "very good."
The researchers were surprised to find no correlation between patient satisfaction and timeliness of pain relief or whether the patients received pain medication. They note that there is a tendency to rely on patient satisfaction scores to determine whether pain management strategies are effective. However, this study showed that patient satisfaction may be high, even if patients experience only minimal reduction in pain. "It may be that other important factors such as the expertise of staff, correct diagnoses, and/or kindness shown overall outweigh the one parameter of pain control," they conclude.
To more accurately assess your pain management, the researchers suggest asking patients directly if they had sufficient analgesia before discharge and asking whether they were satisfied with the pain management they received.
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