Quality improvement activity for improving pain management in acute extremity injuries in the emergency department
Objective The aim of this study was to investigate the effectiveness of a quality improvement activity for pain management in patients with extremity injury in the emergency department (ED). Methods This was a retrospective interventional study. The patient group consisted of those at least 19 years...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Korean Society of Emergency Medicine
2018-03-01
|
| Series: | Clinical and Experimental Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.ceemjournal.org/upload/pdf/ceem-17-260.pdf |
| _version_ | 1797895626852139008 |
|---|---|
| author | Hyung Lan Chang Jin Hee Jung Young Ho Kwak Do Kyun Kim Jin Hee Lee Jae Yun Jung Hyuksool Kwon So Hyun Paek Joong Wan Park Jonghwan Shin |
| author_facet | Hyung Lan Chang Jin Hee Jung Young Ho Kwak Do Kyun Kim Jin Hee Lee Jae Yun Jung Hyuksool Kwon So Hyun Paek Joong Wan Park Jonghwan Shin |
| author_sort | Hyung Lan Chang |
| collection | DOAJ |
| description | Objective The aim of this study was to investigate the effectiveness of a quality improvement activity for pain management in patients with extremity injury in the emergency department (ED). Methods This was a retrospective interventional study. The patient group consisted of those at least 19 years of age who visited the ED and were diagnosed with International Classification of Diseases codes S40–S99 (extremity injuries). The quality improvement activity consisted of three measures: a survey regarding activities, education, and the triage nurse’s pain assessment, including change of pain documentation on electronic medical records. The intervention was conducted from January to April in 2014 and outcome was compared between May and August in 2013 and 2014. The primary outcome was the rate of analgesic prescription, and the secondary outcome was the time to analgesic prescription. Results A total of 1,739 patients were included, and 20.3% of 867 patients in the pre-intervention period, and 28.8% of 872 patients in the post-intervention period received analgesics (P< 0.001). The prescription rate of analgesics for moderate-to-severe injuries was 36.4% in 2013 and 44.5% in 2014 (P=0.026). The time to analgesics prescription was 116.6 minutes (standard deviation 225.6) in 2013 and 64 minutes (standard deviation 75.5) in 2014 for all extremity injuries. The pain scoring increased from 1.4% to 51.6%. Conclusion ED-based quality improvement activities including education and change of pain score documentation can improve the rate of analgesic prescription and time to prescription for patients with extremity injury in the ED. |
| first_indexed | 2024-04-10T07:29:53Z |
| format | Article |
| id | doaj.art-843701a40ff84196a8d79698cf89822f |
| institution | Directory Open Access Journal |
| issn | 2383-4625 |
| language | English |
| last_indexed | 2024-04-10T07:29:53Z |
| publishDate | 2018-03-01 |
| publisher | The Korean Society of Emergency Medicine |
| record_format | Article |
| series | Clinical and Experimental Emergency Medicine |
| spelling | doaj.art-843701a40ff84196a8d79698cf89822f2023-02-24T01:04:00ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252018-03-0151515910.15441/ceem.17.260171Quality improvement activity for improving pain management in acute extremity injuries in the emergency departmentHyung Lan Chang0Jin Hee Jung1Young Ho Kwak2Do Kyun Kim3Jin Hee Lee4Jae Yun Jung5Hyuksool Kwon6So Hyun Paek7Joong Wan Park8Jonghwan Shin9 Department of Emergency Medicines, Seoul National University Hospital, Seoul, Korea Department of Emergency Medicines, SMG-SNU Boramae Medical Center, Seoul, Korea Department of Emergency Medicines, Seoul National University Hospital, Seoul, Korea Department of Emergency Medicines, Seoul National University Hospital, Seoul, Korea Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea Department of Emergency Medicines, Seoul National University Hospital, Seoul, Korea Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea Department of Emergency Medicines, Seoul National University Hospital, Seoul, Korea Department of Emergency Medicines, Seoul National University Hospital, Seoul, Korea Department of Emergency Medicines, SMG-SNU Boramae Medical Center, Seoul, KoreaObjective The aim of this study was to investigate the effectiveness of a quality improvement activity for pain management in patients with extremity injury in the emergency department (ED). Methods This was a retrospective interventional study. The patient group consisted of those at least 19 years of age who visited the ED and were diagnosed with International Classification of Diseases codes S40–S99 (extremity injuries). The quality improvement activity consisted of three measures: a survey regarding activities, education, and the triage nurse’s pain assessment, including change of pain documentation on electronic medical records. The intervention was conducted from January to April in 2014 and outcome was compared between May and August in 2013 and 2014. The primary outcome was the rate of analgesic prescription, and the secondary outcome was the time to analgesic prescription. Results A total of 1,739 patients were included, and 20.3% of 867 patients in the pre-intervention period, and 28.8% of 872 patients in the post-intervention period received analgesics (P< 0.001). The prescription rate of analgesics for moderate-to-severe injuries was 36.4% in 2013 and 44.5% in 2014 (P=0.026). The time to analgesics prescription was 116.6 minutes (standard deviation 225.6) in 2013 and 64 minutes (standard deviation 75.5) in 2014 for all extremity injuries. The pain scoring increased from 1.4% to 51.6%. Conclusion ED-based quality improvement activities including education and change of pain score documentation can improve the rate of analgesic prescription and time to prescription for patients with extremity injury in the ED.http://www.ceemjournal.org/upload/pdf/ceem-17-260.pdfpain managementemergency service, hospitalquality improvement |
| spellingShingle | Hyung Lan Chang Jin Hee Jung Young Ho Kwak Do Kyun Kim Jin Hee Lee Jae Yun Jung Hyuksool Kwon So Hyun Paek Joong Wan Park Jonghwan Shin Quality improvement activity for improving pain management in acute extremity injuries in the emergency department Clinical and Experimental Emergency Medicine pain management emergency service, hospital quality improvement |
| title | Quality improvement activity for improving pain management in acute extremity injuries in the emergency department |
| title_full | Quality improvement activity for improving pain management in acute extremity injuries in the emergency department |
| title_fullStr | Quality improvement activity for improving pain management in acute extremity injuries in the emergency department |
| title_full_unstemmed | Quality improvement activity for improving pain management in acute extremity injuries in the emergency department |
| title_short | Quality improvement activity for improving pain management in acute extremity injuries in the emergency department |
| title_sort | quality improvement activity for improving pain management in acute extremity injuries in the emergency department |
| topic | pain management emergency service, hospital quality improvement |
| url | http://www.ceemjournal.org/upload/pdf/ceem-17-260.pdf |
| work_keys_str_mv | AT hyunglanchang qualityimprovementactivityforimprovingpainmanagementinacuteextremityinjuriesintheemergencydepartment AT jinheejung qualityimprovementactivityforimprovingpainmanagementinacuteextremityinjuriesintheemergencydepartment AT younghokwak qualityimprovementactivityforimprovingpainmanagementinacuteextremityinjuriesintheemergencydepartment AT dokyunkim qualityimprovementactivityforimprovingpainmanagementinacuteextremityinjuriesintheemergencydepartment AT jinheelee qualityimprovementactivityforimprovingpainmanagementinacuteextremityinjuriesintheemergencydepartment AT jaeyunjung qualityimprovementactivityforimprovingpainmanagementinacuteextremityinjuriesintheemergencydepartment AT hyuksoolkwon qualityimprovementactivityforimprovingpainmanagementinacuteextremityinjuriesintheemergencydepartment AT sohyunpaek qualityimprovementactivityforimprovingpainmanagementinacuteextremityinjuriesintheemergencydepartment AT joongwanpark qualityimprovementactivityforimprovingpainmanagementinacuteextremityinjuriesintheemergencydepartment AT jonghwanshin qualityimprovementactivityforimprovingpainmanagementinacuteextremityinjuriesintheemergencydepartment |