Risk Factors for Persistent Post-Surgical Pain: Implementation of a Risk Assessment Questionnaire
Abstract
Background or Problem/Issue Persistent post-surgical pain (PPSP) is a common surgical complication that presents a burden to patients and the health care system. Of all surgical patients, up to 60% are at risk for PPSP. The average annual cost associated with PPSP in 2012 was between $11,846 and $29,617 per patient. Naval Medical Center Portsmouth (NMCP) currently does not have an identification or prevention process for patients at risk for PPSP. Clinical Question or Purpose In patients undergoing general or podiatric surgery at Naval Medical Center Portsmouth, does the implementation of a risk assessment questionnaire improve the identification of patients at risk for persistent post-surgical pain, compared to the current practice over a two-month period? Project Design The ACE Star Model of Knowledge Transformation was used as the organizing framework for this pre- and post-implementation process improvement project. A thorough review of literature was completed and a risk assessment questionnaire was developed in consultation with the NMCP chronic pain service. Anesthesia providers and clinic nurses were educated on the significance of PPSP. Provider knowledge and confidence was assessed pre- and post-education. Nurses in the general surgery and podiatry clinics were instructed to provide the questionnaire to all patients with pre-operative appointments. Screening compliance was assessed over a two-month period. Analysis of the Results Following education, provider knowledge and confidence improved by 27% (p<0.001) and 32.9% (p<0.001), respectively. Overall screening compliance was 29.5% with 16 of 87 (18%) patients screening at risk for PPSP. The implementation of a screening questionnaire improved the identification of patients at risk for PPSP when compared to current practice. Organizational Impact/Implications for Practice The organizational impact of our project is that NMCP now has a working process to screen patients for PPSP.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 22, 2020
- Accession Number
- AD1182658
Entities
People
- Jean Blais
- Keenart Tio
- Larry Beasley
- Raephael Garcia
Organizations
- Uniformed Services University of the Health Sciences