การพัฒนารูปแบบการจัดการความปวดเฉียบพลันหลังผ่าตัด  หน่วยระงับปวดเฉียบพลัน: โรงพยาบาลระนอง

Pinanong Rattanapathumwong; Jintana Buathongjun; Panudchanard Phoosri

Authors

Pinanong Rattanapathumwong Ranong Hospital
Jintana Buathongjun Boromarajonani College of Nursing, Bangkok, Faculty of Nursing, Praboromarajchanok Institute
Panudchanard Phoosri Boromarajonani College of Nursing, Bangkok, Faculty of Nursing, Praboromarajchanok Institute

Keywords:

pain management, postoperative pain, acute pain service

Abstract

Introduction: Postoperative pain management aims to relieve pain and decrease complications from multimodal pain management. However, the current pain management model for acute postoperative pain management of the Ranong Hospital had several limitations, including nurses’ adherence to guidelines pain management outcomes, and adverse drug event related to opioids. Moreover, there was no anesthesiologist in the process of guidelines development. As a result, the development of pain management model is crucial for the optimal outcomes and safety of acute post-operative patients.

Research objectives: 1) To develop a pain management model to control acute postoperative pain and 2) To evaluate the pain management model to control acute postoperative pain in acute pain service, Ranong Hospital.

Research methodology: A research and development method was used to develop a pain management model to control acute postoperative pain. The participants included 249 postoperative patients who received pain management in the surgery and obstetrics gynecology department. This study applied the purposive sampling method to obtain data. We conducted data using Plan-Do-Check-Act or PDCA cycle. Descriptive statistics were used to analyze percentages, mean, and standard deviation. Chi-square was used to compare the old and the new pain management models.

Results: 1) The Acute pain service (APS) developed the pain management model which included multidisciplinary cooperative pain management, creating options to manage postoperative pain using multimodal approach, doctor’s order sheet for managing acute pain after postoperative, monitoring of opioid analgesic adverse effects, applying acute pain nursing diagnosis and care plan following the pain management model. 2) There was significant difference in patient’s satisfaction between the old pain management method and the new pain management model with a statistical level of .05.

Conclusions: The pain management model was practical offering several benefits to patients which included decreasing pain after postoperative, reducing adverse drug events related to opioids, and improving patient's satisfaction.

Implications: The pain management model might be used in other departments of the hospital as a guideline to control pain in patients after postoperative.

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