Establishing Acute Pain Service
Many hospitals have employed an acute pain service for nearly a decade, but for many hospitals in the United States this still is a new idea. What we’re seeing is a new modality in treatment and the way we approach it. An acute pain service (APS) primarily manages pain after traumatic injury or surgery. The basic aspects of an APS include standardization of analgesic techniques, increased pain monitoring and assessment, and the ability to respond to inadequate or excessive doses of analgesics. Establishing an APS, however, takes a lot of persuasion and education, Hospital administrators must be convinced that an APS can benefit the hospital by increasing patient satisfaction (which is strongly associated with adequate pain relief) and by cutting costs through reducing nausea and vomiting, respiratory depression, the incidence of ileus (and thus the length of hospitalization), and the incidence of chronic pain. Physicians and pharmacists need to be willing to accept an APS as part of the care team. Currently, the primary team must request involvement of the APS and that request must be documented in order for the service to be covered by insurers. To get surgeons on board, include them in developing protocols for all analgesic techniques and educate them on the benefits of having multi modal involvement to improve patient’s satisfaction of their overall hospital experience. There are two groups that don’t need convincing about the benefits of an APS – patients and nurses. Still, education of nurses and all staff about the APS is essential. Simply asking nurses to follow written orders is not sufficient, especially for the more advanced pain therapies. Good acute pain care requires a change in culture and attitudes; for example, nurses need assess pain needs and be proactive with interventions, rather than having patients have to call. Nurses need to be educated in pain management. The need for better acute pain management has...
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