Assessment and management of post-operative pain in a teaching hospital: a best practice implementation project

INTRODUCTION: Approximately 75% of patients who undergo surgery experience acute post-operative pain. Among the challenges in managing this pain is the lack of protocols or guidelines to direct interventions and assist professionals in relieving pain more effectively. OBJECTIVE: The aim of this project was to improve the management of acute post-operative pain in adult patients by implementing best practices in three units of a public teaching hospital in Brazil. METHOD: This project was a quasi-experimental intervention study guided by the JBI Evidence Implementation Framework, using the Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) tools. Twelve criteria were used to conduct audits and measure compliance with best practices. A barrier analysis was conducted, along with the development of strategies to overcome them. A total of 144 health care professionals participated and 185 patients' medical records were audited. RESULTS: Two of the three audit criteria related to educational practice showed 100% compliance. Regarding pain assessment, all four criteria showed increased compliance, reaching >60%. The three criteria related to pain management also showed improved compliance. For the two criteria regarding pain reassessment, improvement was seen in only one, which achieved compliance above 60%. CONCLUSION: The implementation of evidence-based practices can effectively reduce the gap between current and best practices. In 10 of the 12 criteria assessed in the audits, compliance exceeded 50%. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A608.