The Development of Pain Management in the Recovery Room, Krabi Hospital

Abstract

This research and development aimed to study situation, problems, and needs of nurse anesthetists in postoperative pain management in recovery room, Krabi hospital. Implementation had 3 stages: Stage 1 was study of situation, problems, and needs of nurse,
anesthetists was analyzed by documents and using qualitative method. That used informants were 15 anesthetists nurses. Data were analyzed using content analysis. Stage 2 was developmented of practice guideline before drafting as practice guideline which was validated by a panel of 3 experts. Stage 3 was study of outcomes of postoperative pain management in recovery room by using one group pretest and posttest quasi-experimental research. Sample were 15 nurse anesthetists and 256 patients. Data were analyzed using descriptive statistics and Wilcoxon signed ranks test. Research results were found as follows;
1. For problems of postoperative pain management in recovery room, Krabi hospital, it was found that nurse anesthetists had workloads, lack of proficiency in medication administration, lack of explicit practice guideline, variety of medication administration, and lack of patients’ reevaluation.
2. Practice guideline of postoperative pain management in recovery room, Krabi hospital consisted of 2 parts including
1) postoperative assessment of pain with every 15 minutes of pain assessment,
2) pain management by using pain assessment with sleepiness scores and analgesics
3. After using practice guideline of postoperative pain management in recovery room, patients had significantly lower and anxiety (p=.001). Patients had, overall, high level of satisfaction of guideline (X̅ = 4.44, SD= 0.38). Nurse anesthetists also had, overall, high level of satisfaction after using guideline (X̅ = 4.28, SD= 0.60).
Therefore, developed practice guideline should be extended to wards in case of limitation of recovery room admission by providing knowledge to ward nurses in consideration of pain score with patients’ ambulation assessment and need of analgesics.