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Survey of pain etiology, management practices and patient satisfaction in two urban emergency departments

Published online by Cambridge University Press:  21 May 2015

Knox H. Todd ,
Edward P. Sloan ,
Connie Chen ,
Stephen Eder  and
Kyle Wamstad
Knox H. Todd*
Affiliation:
Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Ga.
Edward P. Sloan
Affiliation:
Department of Emergency Medicine, University of Illinois College of Medicine, Chicago, Ill.
Connie Chen
Affiliation:
Pharmacia, Inc.
Stephen Eder
Affiliation:
Department of Emergency Medicine, University of Illinois College of Medicine, Chicago, Ill.
Kyle Wamstad
Affiliation:
Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Ga.
*
Emory University School of Medicine, 1101 Juniper St. NE, Ste. 913, Atlanta GA 30309 USA; 404 872-5740, fax 404 872-5747, [email protected]

Abstract:

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Objective:

The underuse of analgesics, or “oligoanalgesia,” is common in emergency departments (EDs). To improve care we must understand our patients’ pain experiences as well as our clinical practice patterns. To this end, we examined pain etiology, pain management practices and patient satisfaction in 2 urban EDs.

Methods:

We conducted a cross-sectional study using structured interviews and chart reviews for patients with pain who presented to either of 2 university-affiliated EDs. We assessed pain etiologies, patient pain experiences, pain management practices, and patient satisfaction with pain management.

Results:

The 525 study subjects reported high pain intensity levels on presentation, with a median rating of 8 on a 10-point numerical rating scale (NRS). At discharge, pain severity had decreased to a median rating of 4; however, 48% of patients were discharged from the ED in moderate to severe pain (NRS 5–10). Subjects reported spending 57% of their ED stay in moderate to severe pain. Analgesics were administered to only 50% of patients. The mean time to analgesic administration was almost 2 hours. Despite high levels of reported pain at discharge and low rates of analgesic administration, subjects reported high satisfaction with pain management.

Conclusions:

In the 2 EDs studied, we found high levels of pain severity for our patients, as well as low levels of analgesic use. When used, analgesic administration was often delayed. Despite these findings, patient satisfaction remained high. Despite recent efforts to improve pain management practice; oligoanalgesia remains a problem for our specialty.

Keywords

painpain measurementpatient satisfactionanalgesicsquality assuranceoligoanalgesia
Type
EM Advances • Innovations en MU
Information
Canadian Journal of Emergency Medicine , Volume 4 , Issue 4 , July 2002 , pp. 252 - 256
Copyright
Copyright © Canadian Association of Emergency Physicians 2002

References

1.Wilson, JE, Pendleton, JM.Oligoanalgesia in the emergency department. Am J Emerg Med 1989;7:620–3.CrossRefGoogle ScholarPubMed
2.Selbst, SM, Clark, M.Analgesic use in the emergency department. Ann Emerg Med 1990;19:1010–3.CrossRefGoogle ScholarPubMed
3.Todd, KH, Samaroo, N, Hoffman, JR.Ethnicity as a risk factor for inadequate emergency department analgesia. JAMA 1993; 269:1537–9.CrossRefGoogle ScholarPubMed
4.Todd, KH, Deaton, C, D’Adamo, AP, Goe, L.Ethnicity and analgesic practice. Ann Emerg Med 2000;35:11–6.CrossRefGoogle ScholarPubMed
5.Ducharme, J, Barber, C.A prospective blinded study on emergency pain assessment and therapy. J Emerg Med 1995;13:571–5.CrossRefGoogle Scholar
6.Joint Commission on Accreditation of Healthcare Organizations. Pain Standards for 2001. Available: www.jcaho.org/trkhco_frm.html (accessed 2002 May 8).Google Scholar
7.Cuzick, J.A Wilcoxon-type test for trend. Stat Med 1985;4:87–90.CrossRefGoogle ScholarPubMed
8.Hoyt, KS, Sparger, G.Pain assessment by ED nurses. J Emerg Nurs 1984;10:306–12.Google Scholar
9.Boisaubin, EV.The assessment and treatment of pain in the emergency room. Clin J Pain 1989;5:S19–24.Google Scholar
10.Johnston, CC, Gagnon, AJ, Fullerton, L, Common, C, Ladores, M, Forlini, S.One-week survey of pain intensity on admission to and discharge from the emergency department: a pilot study. J Emerg Med 1998;16:377–82.CrossRefGoogle ScholarPubMed
11.Tanabe, PO, Buschmann, M.A prospective study of ED pain management practices and the patient’s perspective. J Emerg Nurs 1999;25:171–7.Google Scholar
12.Guru, V, Dubinsky, I.The patient vs. caregiver perception of acute pain in the emergency department. J Emerg Med 2000;18:7–12.Google Scholar
13.Stahmer, SA, Shofer, FS, Marino, A, Shepherd, S, Abbuhl, S.Do quantative changes in pain intensity correlate with pain relief and satisfaction? Acad Emerg Med 1998;5:851–7.CrossRefGoogle Scholar
14.Blanchard, DK, Todd, KH.More satisfactory measures of emergency department patient satisfaction [abstract]. Acad Emerg Med 1997;4:498.Google Scholar