Pain relief during deep-open wound dressing change in a traumatic orthopedics department: a best practice implementation project.

Abstract

OBJECTIVES The aim of this project was to implement best practice in pain relief during wound care for patients with deep-open wounds in the trauma orthopedics department of a tertiary teaching hospital in China. INTRODUCTION Patients with deep-open wounds often suffer from great pain during wound care. Inadequate pain relief for such patients in hospital calls for evidence-based changes to close the current practice gap. METHODS The current quality improvement project was carried out over six months using the Joanna Briggs Institute Practical Application of Clinical Evidence System, a baseline and two follow-up audits of wound pain management practice were conducted to identify practice gaps and post implementation compliance in pain management in wound care. The sample comprised 20 patients and two dressing nurses. The Getting Research into Practice tool identified barriers to and strategies for improvement in practice. The patients' pain experience was measured following the implementation of changes. RESULTS The baseline audit identified poor compliance with best practice. Following implementation of the recommended changes, significant improvements in practice were made by the dressing nurses and were inadequately maintained at the second post implementation audit. Patients' pain scores improved following the nurses' practice changes (t = 2.272, P > 0.05). CONCLUSION The implementation of best practice in pain relief during wound care for patients with deep-open wounds has led to significant improvement in nurses' performance in the traumatic orthopedics department. The most challenging barriers involved interdisciplinary collaborations and organizational structure.