This eliminates much of the
patients' control over managing
their pain and results in
patients waiting, in pain, for a
nurse to bring their pain
tablets. When PCA is
administered in the hospital
setting, it is most often
administered by intravenous,
subcutaneous, or epidural
routes. This article describes
the implementation of a
successful inpatient program
that offers patient-controlled
oral analgesia (PCOA).
Patient-centered care is "an
approach that consciously adopts
the patient's
perspective...about what
matters." Patient-centered care
is the practice philosophy of
the University Health Network, a
large tri-site teaching hospital
in downtown Toronto, Ontario,
Canada, affiliated with the
University of Toronto. This
philosophy underpins the concept
of PCOA as it has been
successfully operationalized in
a unique PCOA program at the
Toronto Western Hospital, one of
the three sites comprising the
University Health Network.
Source:http://www.medscape.com/viewarticle/
546940
|
Undertreatment of
Postoperative Pain Have
Serious Consequences |
Despite medical, technologic,
and pharmaceutical advancement
in the past decade, inadequate
management of postoperative pain
remains common (Coley, Williams,
DaPos, Chen, & Smith, 2002;
Watt-Watson, Garfinkel, Gallop,
Stevens, & Streiner, 2000;
Watt-Watson, Stevens, Costello,
Katz, & Reid, 2000).
Approximately 80% of patients
experience acute pain after
surgery, and of these, 47%
report severe or extreme pain (Apfelbaum,
Chen, Mehta, & Gan, 2003).
Adverse effects of unrelieved
pain include deep vein
thrombosis, pulmonary embolism,
coronary ischemia, myocardial
infarction, pneumonia, poor
wound healing, insomnia, and
demoralization (Carr & Goudas,
1999). In addition, undertreated
pain can result in longer
intensive care unit and hospital
stays (Bertollni et al., 2002),
interference with activities of
daily living at discharge
(Moore, 1994), and a high
incidence of chronic pain
development (Katz, Jackson,
Kavanagh, & Sandler, 1996).
