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Revista de la Sociedad Española del Dolor
versión impresa ISSN 1134-8046
Resumen
SAMPER BERNAL, D et al. Optimization of postoperative pain management based on a new technological tool. Pain map. Rev. Soc. Esp. Dolor [online]. 2019, vol.26, n.3, pp.154-165. Epub 23-Mar-2020. ISSN 1134-8046. https://dx.doi.org/10.20986/resed.2019.3696/2018.
Introduction:
In 2005, the Ministry of Health, Social Services and Equality (MSSSI) promoted the Patient Safety Strategy of the National Health System (SNS), in collaboration with the Autonomous Communities, which integrated the contributions of health professionals and patients through their organizations.
One of the objectives of safe practices was the need for prevention and control of pain in adults and children, including management of the same in quality standards.
At the Germans Trias and Pujol University Hospital (HUGTIP) in 2016, the development of the indicators that were intended to be evaluated for better detection and therapeutic efficiency of acute in-hospital pain in any area ended with the design and creation of what we call as "pain map".
The objective was to design a tool that, through the clinical pain variable, could improve the visualization of pain and extract statistical data from the defined indicators for optimal pain management in a university hospital of the third level.
Material and method:
Descriptive analysis of the tool we call pain map at the Germans Trias and Pujol University Hospital during 2016. The population was all patients admitted to hospital units where the pain registry was made through the GacelaCare® computerized medical record.
The main variable was the recording of pain intensity using the Visual Analogue Scale (VAS) or Numeric Verbal Scale (NVA) by nursing shift considering pain as the 5th constant. The tool creation procedure was carried out with the collaboration of the hospital information systems department together with members of the Pain Unit for the elaboration of the so-called pain map.
Results:
The pain map is based on the previous action required by nursing which is the recording of the intensity of pain using the Visual Analogue Scale (VAS) or Numerical Verbal Scale (NVA) in turn considering pain as the 5th constant.
The map allows to visualize on the screen the registers of the pain intensity of all hospitalized patients simultaneously and in real time.
The pain map identifies with different colors as a traffic light of pain. In green color, the EVN values are between 0-3 (mild pain), orange EVN between 4 and 6 (moderate pain) and red color between 7 and 10 (intense pain). Likewise, it indicates with a purple band those patients operated on the previous day, facilitating pain control during the first 24 postoperative hours.
The statistical exploitation of computerized pain registers allows obtaining results of the quality indicators related to pain management defined by our hospital.
Discussion:
The pain map is an innovative tool that allows the development of low-cost Acute Pain Units to be guaranteed with efficiency.
Palabras clave : Pain; pain management; integrated and advanced information management systems; indicators of quality in health care; postoperative pain.