An audit and feedback (A&F) intervention program helped nurses improve perioperative pain management in older adults hospitalized for hip fracture, a new study finds.
The research showed that less than a quarter of people were receiving the appropriate dose of acetaminophen despite routine medical prescriptions for it; significantly more people got the correct medication as a result of the intervention. It included training nurses on the concept of pain, giving them a pain management scale and updating the pain management protocol.
The report was published Thursday in BMC Geriatrics.
Researchers conducted a study to see how well an A&F intervention worked. They compared older adults hospitalized for hip fracture in an orthogeriatric unit whose nurses used the intervention with similar patients on a traditional orthopedic unit where no intervention was provided. The primary goal was to evaluate the percentage of patients who received 3 grams per day of acetaminophen during the three days after the operation. The team also evaluated how well nurses adhered to medical prescriptions.
In total, investigators looked at data from 397 people with an average age of 89 years. Of them, 75% were women.
After their operation but before the intervention began, 16% of people receiving the intervention received 3 grams per day of acetaminophen; after the intervention, 60% of people received the medicine after their operations.
The likelihood of receiving 3 grams per day of acetaminophen during the postoperative period and adhering to the medical prescription of acetaminophen were significantly increased in the group subject to the intervention compared with the group that didn’t.
The functional status of patients who received the intervention was better when they were discharged, and the intervention reduced the length of hospital stays.
“Our study directly measured the effect of our multimodal intervention on nurses’ attitudes and practices,” the authors wrote.
The authors said their intervention program improved pain management, which enhanced the mobility of patients during their hospital stays.
Acetaminophen is a first-line therapy for pain management in older adults, especially during perioperative periods. Healthcare providers typically minimize the use of opioids, the authors wrote.
“Strong opioid distribution did not decrease following the audit and feedback intervention, but our study did not aim to compare optimal pain management with non-optimal pain management,” the authors pointed out.
