Key result
A multi-method approach including literature review, incident report analysis, and a Delphi panel yielded a final set of 15 indicators for assessing inpatient pharmacological pain management quality.
A combination of literature search, critical incident reporting analysis, and expert interviews successfully generated a 15-item indicator set for assessing inpatient pain management quality.
May support inpatient pain management quality assessment; leaves open prospective validation before clinical adoption.
Background Analgesics represent one of the most frequently administered drugs during hospital stay. It is estimated that 40–80% of inpatients suffer from intermittent pain during their stay. In the current literature, indicators are considered an efficient, targeted method for the assessment of drug therapy quality. However, little is known about useful methods of identifying indicators for the quality of pharmacological therapy for pain. Purpose The aim of this work was to design an indicator development method and subsequent indicator set for the assessment of pharmacological pain management quality with a primary focus on safety, and secondarily efficacy, in the inpatient setting. Indicator development process The following strategies were used: (i) a systematic literature review (PubMed, Embase and Scopus); (ii) analysis of a critical incident reporting system, encompassing 1557 reports from 37 hospitals; and (iii) semistructured expert interviews. A list of 172 pain related indicators was compiled. The 56 most pain specific indicators were subsequently evaluated in a Delphi panel. The final set consisted of 15 indicators: nine were chosen based on the risk priority number, seven according to expert rating of their overall relevance. The three highest rated indicators were: (1) patients treated with non-steroidal anti-inflammatory drugs AND creatinine clearance <60 ml/min; (2) standard use of a visual analogue scale for pain assessment; and (3) paracetamol >4 g/day. Conclusion A combination of literature search, analysis of a critical incident reporting system and expert interviews was useful for the indicator development. Although indicators could be well rated based on risk priority number, process and structure indicators were better assessed based on their attributed relevance.
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Meyer‐Massetti et al. (2012) studied Pain management. Indicator development method was evaluated on Development of an indicator set for the assessment of pharmacological pain management quality. A multi-method approach including literature review, incident report analysis, and a Delphi panel yielded a final set of 15 indicators for assessing inpatient pharmacological pain management quality.
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