Development of Clinical Practice Guidelines for Pain Management Among Patients Undergoing Open Heart Surgery

Abstract

Pain after open heart surgery impacts patients physically and mentally, necessitating effective management. This developmental research aimed to develop clinical practice guidelines (CPGs) for pain management among patients undergoing open heart surgery. The study framework was based on the development of CPGs recommended by the Australian National Health and Medical Research Council (NHMRC, 1999). The participants consisted of 1) 3 nurses using the CPGs, and 2) 3 patients undergoing open heart surgery. Data collection instruments included: 1) a demographic data record form, 2)a pain assessment form on postoperative cardiac surgery with reliability index of 0.84,                           3) a questionnaire on patient satisfaction with pain management with reliability index of 0.83 and 4) a questionnaire on feasibility of CPGs. Data were analyzed using descriptive statistics include frequency, percentage, mean, and standard deviation.The results revealed that the CPGs for pain management among patients undergoing open heart surgery consisted of 1) preoperative patient assessment and pain management education; 2) pain severity assessment, cause of pain and postoperative pain management; 3) evaluation after pain management; 4) dosage adjustment according to treatment plan or change of pain management method according to pain severity; 5) managing pain medication side effects; and 6) monitoring of pain management and documentation of pain score. The feasibility for implementation was at a high level. Patients have lower incidence of mild chest wound pain and pain interference was reported less frequently. Additionally, satisfaction with pain management was high level. The findings of this study indicate that these CPGs are practical and effective for individuals undergoing open heart surgery. Therefore, further studies should consider the outcome of implementation.