{"title":"Effectiveness of implementing a Best Practice Guideline recommendations to manage pain in oncological hospitalized patients","authors":"Ana-Isabel Alcañiz-Mesas , María-Victoria Ruiz-García , María-Pilar Córcoles-Jiménez , María-José Caballero-García , María Teresa González Álvarez","doi":"10.1016/j.enfcle.2024.11.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of implementing the Clinical Best Practice Guideline (BPG) “Assessment and Management of Pain” recommendations for pain control in oncological/oncohaematological hospitalized patients.</div></div><div><h3>Methods</h3><div>Ambispective cohort study. Sample and Setting: Adults admitted to oncological unit in Hospital of Albacete.</div></div><div><h3>Intervention</h3><div>Implementation of GBP recommendations. Variables: 1) Demographic data. 2)On implementation of GBP recommendations. 3) Outcome in patients: pain intensity in the first 24 h after admission and maximum intensity during admission Tools: Numeric and Visual Scales. Data collection: indicators exported from clinical history for evaluation of the BPSO® program. Ethical aspects: anonymous data. Data analysis (SPSS®): Descriptive during periods: baseline (T0 = December 2015); initial (T1 = 2017); consolidation (T2 = 2018–2019); sustainability (T3 = 2021–2022). Measurements of central tendency and dispersion, absolute and relative frequencies. Comparison of proportions (Chi-Square) and averages (Student t-test, ANOVA). Statistical significance: p < 0.05.</div></div><div><h3>Results</h3><div>Included 572 patients, 61.5% (352) men. Daily intervention of pain detection was performed in 94.6% (538) of patients (20%–T0; 98.3%–T1; 98.4%–T2; 91.2%–T3; p < 0.001), pain assessment using an appropriate scale in 97.6% (558) (0%–T0; 98.3%–T1; 99.2%–T2; 100%–T3; p < 0.001); 93.7% (535) had a care plan for assessment and management of pain (0%–T0; 98.3%–T1; 96.3%–T2; 92.3%–T3; p < 0.001). The percentage of patients who had severe pain (6–10) during the first 24 hours was reduced from T1 to T3 (5.1%–T1; 6.6%–T2; 2.1%–T3; p = 0.145), but throughout hospitalization increased from T1 to T3 (19.2%–T1; 17%–T2; 22.5%–T3; p = 0.21).</div></div><div><h3>Conclusions</h3><div>Implementation of recommendations has led to a statistically significant improvement over the periods in the study; however, no effectiveness has been shown to reduce pain intensity.</div></div>","PeriodicalId":72917,"journal":{"name":"Enfermeria clinica (English Edition)","volume":"34 6","pages":"Pages 448-457"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Enfermeria clinica (English Edition)","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2445147924000924","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
To evaluate the effectiveness of implementing the Clinical Best Practice Guideline (BPG) “Assessment and Management of Pain” recommendations for pain control in oncological/oncohaematological hospitalized patients.
Methods
Ambispective cohort study. Sample and Setting: Adults admitted to oncological unit in Hospital of Albacete.
Intervention
Implementation of GBP recommendations. Variables: 1) Demographic data. 2)On implementation of GBP recommendations. 3) Outcome in patients: pain intensity in the first 24 h after admission and maximum intensity during admission Tools: Numeric and Visual Scales. Data collection: indicators exported from clinical history for evaluation of the BPSO® program. Ethical aspects: anonymous data. Data analysis (SPSS®): Descriptive during periods: baseline (T0 = December 2015); initial (T1 = 2017); consolidation (T2 = 2018–2019); sustainability (T3 = 2021–2022). Measurements of central tendency and dispersion, absolute and relative frequencies. Comparison of proportions (Chi-Square) and averages (Student t-test, ANOVA). Statistical significance: p < 0.05.
Results
Included 572 patients, 61.5% (352) men. Daily intervention of pain detection was performed in 94.6% (538) of patients (20%–T0; 98.3%–T1; 98.4%–T2; 91.2%–T3; p < 0.001), pain assessment using an appropriate scale in 97.6% (558) (0%–T0; 98.3%–T1; 99.2%–T2; 100%–T3; p < 0.001); 93.7% (535) had a care plan for assessment and management of pain (0%–T0; 98.3%–T1; 96.3%–T2; 92.3%–T3; p < 0.001). The percentage of patients who had severe pain (6–10) during the first 24 hours was reduced from T1 to T3 (5.1%–T1; 6.6%–T2; 2.1%–T3; p = 0.145), but throughout hospitalization increased from T1 to T3 (19.2%–T1; 17%–T2; 22.5%–T3; p = 0.21).
Conclusions
Implementation of recommendations has led to a statistically significant improvement over the periods in the study; however, no effectiveness has been shown to reduce pain intensity.