| Peer-Reviewed

Optimizing Post-Surgical Pain Management in Adult Surgical Patients: Effects of Training Interventions on Surgical Nurses’ Knowledge

Received: 17 March 2022    Accepted: 6 April 2022    Published: 14 April 2022
Views:       Downloads:
Abstract

Context: There is a surplus of contemporary scientific evidence-based indicated numerous precarious positions with inadequate post-surgical pain management in adult surgical patients. The most important barrier in this context was suboptimal postsurgical pain interventions. Aim: This nursing improvement initiative aimed to optimize post-surgical pain nursing interventions in adult surgical patients by training surgical nurses the strategies to enhance their pain management competencies in one teaching hospital in Saudi Arabia. Materials and methods: A descriptive, cross-sectional pain prevalence survey was conducted quarterly in all eight adult surgical inpatients wards to determine and assess if their pain was controlled to a satisfactory level of less than moderate pain. Secondly, pre-and post-test surgical nurses’ knowledge assessment surveys were conducted. Descriptive statistics were used to analyze and interpret and present the data. Results: The outcomes demonstrated that through the improvement nursing initiative strategies implemented, the pain prevalence survey in February 2020 improved by more than 9% with an average of 93.4% (n=142; N=152) of patients with pain intensity less than moderate pain, while in September after omitting quarter three due to Covid-19 surge, all eight surgical wards achieved an average of 88% (n=152; N=173), thus improved by 3,6% compared to the results of November 2019. The average pretest pain knowledge assessment survey taken in January 2020 by 103 surgical nurses in all eight surgical wards was 71%. In October 2020, 114 surgical nurses participated in the post-test and achieved 83%, demonstrated an increase of more than 12% from all 20 questions. Conclusion: The eight surgical wards substantially achieved more than 80% of patients with controlled postsurgical pain levels of less than moderate pain during the last two prevalence cycles, and the posttest revealed pain management knowledge acquisition from the baseline of the pretest conducted. It is therefore postulated that it is essential to monitor the pain management quality of delivered patient nursing care interventions based on the type of pain and consider the provision of refresher training sessions to influence practical skills of pain management competencies.

Published in American Journal of Nursing Science (Volume 11, Issue 2)
DOI 10.11648/j.ajns.20221102.14
Page(s) 70-76
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Prevalence Surveys, Pain Management Training, Post-surgical Pain, Surgical Nurses

References
[1] Gan, T. J. J. J. o. p. r. (2017). Poorly controlled postoperative pain: prevalence, consequences, and prevention. 10, 2287. doi: 10.2147/JPR.S144066.
[2] Kehlet, H. J. P. (2018). Postoperative pain, analgesia, and recovery—bedfellows that cannot be ignored. 159, S11-S16. doi: 10.1097/j.pain.0000000000001243.
[3] John, E. B., Kaufmann, M. W., Barnhart, R. A., Baratta, J. L., & Schwenk, E. S. (2019). Acute pain. In Academic Pain Medicine (pp. 167-175): Springer. doi: 10.1007/978-3-030-18005-8_27.
[4] Ojo, A. (2019). The Use of Aromatherapy to Improve Post-Operative Perception of Pain. Grand Canyon University.
[5] Cifu, D. X. (2020). Braddom's Physical Medicine and Rehabilitation E-Book: Elsevier Health Sciences.
[6] Watson, R. R., & Zibadi, S. (2017). Nutritional Modulators of Pain in the Aging Population: Elsevier Science.
[7] Lavand'homme, P. J. P. (2017). Transition from acute to chronic pain after surgery. 158, S50-S54. doi: 10.1097/j.pain.0000000000000809.
[8] Pozek, J.-P. J., De Ruyter, M., & Khan, T. W. J. A. c. (2018). Comprehensive acute pain management in the perioperative surgical home. 36 (2), 295-307. doi: 10.1016/j.anclin.2018.01.007.
[9] Gulur, P., & Nelli, A. J. C. O. i. A. (2019). Persistent postoperative pain: mechanisms and modulators. 32 (5), 668-673. doi: 10.1097/ACO.0000000000000770.
[10] Check, J. J. C., obstetrics, e., & gynecology. (2021). Chronic pelvic pain syndromes–traditional and novel therapies: part I surgical therapy. 38 (1), 10-13.
[11] Glare, P., Aubrey, K. R., & Myles, P. S. J. T. L. (2019). Transition from acute to chronic pain after surgery. 393 (10180), 1537-1546. doi: 10.1016/S0140-6736(19)30352-6.
[12] Jones, M. R., Kramer, M. E., Beutler, S. S., Kaye, A. D., Rao, N., & Brovman, E. Y. et al. (2020). The association between potential opioid-related adverse drug events and outcomes in total knee arthroplasty: a retrospective study. 37 (1), 200-212. doi: 10.1007/s12325-019-01122-1.
[13] Hansen, T. B. J. E. o. r. (2017). Fast track in hip arthroplasty. 2 (5), 179-188. doi: 10.1302/2058-5241.2.160060.
[14] Jones, J., Southerland, W., & Catalani, B. J. O. C. (2017). The importance of optimizing acute pain in the orthopedic trauma patient. 48 (4), 445-465. doi: 10.1016/j.ocl.2017.06.003.
[15] Pędziwiatr, M., Mavrikis, J., Witowski, J., Adamos, A., Major, P., & Nowakowski, M. et al. (2018). Current status of enhanced recovery after surgery (ERAS) protocol in gastrointestinal surgery. 35 (6), 1-8. doi: 10.1007/s12032-018-1153-0.
[16] Benson, S., Hagen, S., Hoffmann, O., Pasler, A., Bingel, U., & Schedlowski, M. et al. (2019). Can a brief psychological expectancy intervention improve postoperative pain? A randomized, controlled trial in patients with breast cancer. 160 (7), 1562-1571. doi: 10.1097/j.pain.0000000000001546.
[17] Hadlandsmyth, K., Conrad, M., Steffensmeier, K. S., Van Tiem, J., Obrecht, A., & Cullen, J. J. et al. (2020). Enhancing the Biopsychosocial Approach to Perioperative Care: A Pilot Randomized Trial of the Perioperative Pain Self-Management (PePS) Intervention. Annals of Surgery. 275 (1), p e8-e14. doi: 10.1097/SLA.0000000000004671.
[18] Makhlouf, M. M., Garibay, E. R., Jenkins, B. N., Kain, Z. N., & Fortier, M. A. J. P. m. (2019). Postoperative pain: factors and tools to improve pain management in children. 9 (4), 389-397. doi: 10.2217/pmt-2018-0079.
[19] Zaouter, C., Oses, P., Assatourian, S., Labrousse, L., Rémy, A., & Ouattara, A. J. J. o. c. et al. (2019). Reduced length of hospital stay for cardiac surgery—implementing an optimized perioperative pathway: prospective evaluation of an enhanced recovery after surgery program designed for mini-invasive aortic valve replacement. 33 (11), 3010-3019. doi: 10.1053/j.jvca.2019.05.006.
[20] Cui, C., Wang, L. X., Li, Q., Zaslansky, R., & Li, L. J. J. o. c. n. (2018). Implementing a pain management nursing protocol for orthopaedic surgical patients: Results from a PAIN OUT project. 27 (7-8), 1684-1691. doi: 10.1111/jocn.14224.
[21] Dequeker, S., Van Lancker, A., & Van Hecke, A. J. J. o. a. n. (2018). Hospitalized patients’ vs. nurses’ assessments of pain intensity and barriers to pain management. 74 (1), 160-171. doi.org/10.1111/jan.13395.
[22] Samarkandi, O. A. J. S. j. o. a. (2018). Knowledge and attitudes of nurses toward pain management. 12 (2), 220-226. doi: 10.4103/sja.SJA_587_17.
[23] Smeland, A. H., Rustøen, T., Næss, T., Nybro, L., Lundeberg, S., & Reinertsen, H. et al. (2019). Children’s views on postsurgical pain in recovery units in Norway: A qualitative study. 28 (11-12), 2157-2170. doi: 10.1111/jocn.14788.
[24] Yajnik, M., Hill, J. N., Hunter, O. O., Howard, S. K., Kim, T. E., & Harrison, T. K. et al. (2019). Patient education and engagement in postoperative pain management decreases opioid use following knee replacement surgery. 102 (2), 383-387. doi: 10.1016/j.pec.2018.09.001.
[25] Ljungqvist, O., Francis, N. K., & Urman, R. D. (2020). Enhanced Recovery After Surgery: A Complete Guide to Optimizing Outcomes: Springer International Publishing.
[26] Reaza-Alarcón, A., & Rodríguez-Martín, B. J. I. y. e. e. e. (2019). Effectiveness of nursing educational interventions in managing post-surgical pain. Systematic review. 37 (2).
[27] Rabbitts, J. A., Palermo, T. M., & Lang, E. A. J. J. o. P. R. (2020). A conceptual model of biopsychosocial mechanisms of transition from acute to chronic postsurgical pain in children and adolescents. 13, 3071. doi: 10.2147/JPR.S239320.
[28] Riswold, K., Brech, A., Petersen, R., Schepper, S., Wegehaupt, A., & Larsen-Engelkes, T. J. et al. (2018). A Biopsychosocial Approach to Pain Management. 71 (11).
[29] Taylor, I., & Wilson, S. A. (2020). Managing pain. In Clinical Challenges (pp. 3-23): Routledge.
[30] Ghotra, J. K. (2020). Nitrous Oxide for Pain Management in the Emergency Department.
[31] Osypiuk, K., Ligibel, J., Giobbie-Hurder, A., Vergara-Diaz, G., Bonato, P., & Quinn, R. et al. (2020). Qigong mind-body exercise as a biopsychosocial therapy for persistent post-surgical pain in breast cancer: a pilot study. 19, 1534735419893766. doi: 10.1177/1534735419893766.
[32] Garcia, J. B. S., Bonilla, P., Kraychete, D. C., Flores, F. C., Valtolina, E. D. P. d., & Guerrero, C. J. R. b. d. a. (2017). Optimizing post-operative pain management in Latin America. 67, 395-403. doi: 10.1016/j.bjane.2017.10.004.
[33] Kusi Amponsah, A., Oduro, E., Bam, V., Kyei-Dompim, J., Ahoto, C. K., & Axelin, A. J. B. P. (2020). Dynamics on the field: a focused study on the culture and context of pediatric pain management at four Ghanaian hospitals. 20 (1), 1-14. doi: 10.1186/s12887-020-02399-w.
[34] Wylde, V., Beswick, A., Bruce, J., Blom, A., Howells, N., & Gooberman-Hill, R. J. E. o. r. (2018). Chronic pain after total knee arthroplasty. 3 (8), 461-470. doi: 10.1302/2058-5241.3.180004.
[35] Mahmood, T., Choudhury, M. R., Islam, M. N., Haq, S. A., Shahin, M. A., & Ali, S. M. M. et al. (2020). Translation, cross-cultural adaptation and validation of the English Lequesne Algofunctional index in to Bengali. 18 (1), 1-9. doi: 10.1186/s12955-020-01583-x.
[36] Manlapaz, D., Escuadra, C. J., Averia, J. K. C., Blancaflor, A., Ann, R. J. T., & fallers, v. o. t. P. A. S. f. t. E. i. F. c.-d. o. a. et al. (2019). Test-retest reliability, internal consistency, and discriminant validity of the Filipino version of Knee injury and Osteoarthritis Outcome Score among community-dwellers with knee osteoarthritis. 53. doi: 10.36413/pjahs.0301.002.
[37] Held, B., Moriarty, B., & Richardson, T. (2019). Microsoft Excel Functions and Formulas with Excel 2019/Office 365: Stylus Publishing, LLC.
[38] Clarke, J. L., Skoufalos, A., & Scranton, R. J. P. h. m. (2016). The American opioid epidemic: population health implications and potential solutions. Report from the National Stakeholder Panel. 19 (S1), S-1-S-10. doi: 10.1089/pop.2015.0144.
[39] Meissner, W., Huygen, F., Neugebauer, E. A., Osterbrink, J., Benhamou, D., & Betteridge, N. et al. (2018). Management of acute pain in the postoperative setting: the importance of qualityindicators. 34 (1), 187-196. doi: 10.1080/03007995.2017.1391081.
[40] Menlah, A., Garti, I., Amoo, S. A., Atakro, C. A., Amponsah, C., & Agyare, D. F. J. S. O. N. (2018). Knowledge, attitudes, and practices of postoperative pain management by nurses in selected district hospitals in Ghana. 4, 2377960818790383. doi: 10.1177/2377960818790383.
[41] Durham, M. L., Egan, A., Jankiewicz, A., Murphy, M. P., Nedved, P., & Luvich, R. et al. (2017). Addressing safe opioid monitoring practices using an interprofessional approach. 47 (11), 537-544. doi: 10.1097/NNA.0000000000000540.
[42] Gordon, D. B., Watt-Watson, J., & Hogans, B. B. J. P. r. (2018). Interprofessional pain education—with, from, and about competent, collaborative practice teams to transform pain care. 3 (3). doi: 10.1097/PR9.0000000000000663.
[43] Watt-Watson, J., Lax, L., Davies, R., Langlois, S., Oskarsson, J., & Raman-Wilms, L. J. P. M. (2017). The pain interprofessional curriculum design model. 18 (6), 1040-1048. doi: 10.1093/pm/pnw337.
[44] Watt-Watson, J., Siddall, P. J., & Carr, E. J. P. m. (2012). Interprofessional pain education: The road to successful pain management outcomes. 2 (5), 417-420. doi: 10.2217/pmt.12.46.
[45] O’Donovan, J., O’Donovan, C., Kuhn, I., Sachs, S. E., & Winters, N. (2018). Ongoing training of community health workers in low-income and middle-income countries: a systematic scoping review of the literature. 8 (4), e021467. doi: 10.1136/bmjopen-2017-021467%JBMJOpen.
[46] Guraya, S. Y., & Barr, H. J. T. K. j. o. m. s. (2018). The effectiveness of interprofessional education in healthcare: A systematic review and meta-analysis. 34 (3), 160-165. doi: 10.1016/j.kjms.2017.12.009.
[47] Simko, L. C., Rhodes, D. C., McGinnis, K. A., & Fiedor, J. J. A. j. o. p. e. (2017). Students’ perspectives on interprofessional teamwork before and after an interprofessional pain education course. 81 (6). doi: 10.5688/ajpe816104.
[48] Vieira, A. L., Nespeca, M. G., Pavini, W. D., Ferreira, E. C., Neto, J. A. G. J. C., & Systems, I. L. (2019). A user-friendly excel spreadsheet for dealing with spectroscopic and chromatographicdata. 194, 103816. doi: 10.1016/j.chemolab.2019.103816.
[49] Levy, N., Mills, P., & Rockett, M. J. B. j. o. a. (2019). Post-surgical pain management: time for a paradigm shift. 123 (2), e182-e186. doi: 10.1016/j.bja.2019.05.031.
Cite This Article
  • APA Style

    Nabeeha Tashkandi, Laura Taylor, Litaba Efraim Kolobe, Sharon Chellan, Loh Cheng Cheng. (2022). Optimizing Post-Surgical Pain Management in Adult Surgical Patients: Effects of Training Interventions on Surgical Nurses’ Knowledge. American Journal of Nursing Science, 11(2), 70-76. https://doi.org/10.11648/j.ajns.20221102.14

    Copy | Download

    ACS Style

    Nabeeha Tashkandi; Laura Taylor; Litaba Efraim Kolobe; Sharon Chellan; Loh Cheng Cheng. Optimizing Post-Surgical Pain Management in Adult Surgical Patients: Effects of Training Interventions on Surgical Nurses’ Knowledge. Am. J. Nurs. Sci. 2022, 11(2), 70-76. doi: 10.11648/j.ajns.20221102.14

    Copy | Download

    AMA Style

    Nabeeha Tashkandi, Laura Taylor, Litaba Efraim Kolobe, Sharon Chellan, Loh Cheng Cheng. Optimizing Post-Surgical Pain Management in Adult Surgical Patients: Effects of Training Interventions on Surgical Nurses’ Knowledge. Am J Nurs Sci. 2022;11(2):70-76. doi: 10.11648/j.ajns.20221102.14

    Copy | Download

  • @article{10.11648/j.ajns.20221102.14,
      author = {Nabeeha Tashkandi and Laura Taylor and Litaba Efraim Kolobe and Sharon Chellan and Loh Cheng Cheng},
      title = {Optimizing Post-Surgical Pain Management in Adult Surgical Patients: Effects of Training Interventions on Surgical Nurses’ Knowledge},
      journal = {American Journal of Nursing Science},
      volume = {11},
      number = {2},
      pages = {70-76},
      doi = {10.11648/j.ajns.20221102.14},
      url = {https://doi.org/10.11648/j.ajns.20221102.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20221102.14},
      abstract = {Context: There is a surplus of contemporary scientific evidence-based indicated numerous precarious positions with inadequate post-surgical pain management in adult surgical patients. The most important barrier in this context was suboptimal postsurgical pain interventions. Aim: This nursing improvement initiative aimed to optimize post-surgical pain nursing interventions in adult surgical patients by training surgical nurses the strategies to enhance their pain management competencies in one teaching hospital in Saudi Arabia. Materials and methods: A descriptive, cross-sectional pain prevalence survey was conducted quarterly in all eight adult surgical inpatients wards to determine and assess if their pain was controlled to a satisfactory level of less than moderate pain. Secondly, pre-and post-test surgical nurses’ knowledge assessment surveys were conducted. Descriptive statistics were used to analyze and interpret and present the data. Results: The outcomes demonstrated that through the improvement nursing initiative strategies implemented, the pain prevalence survey in February 2020 improved by more than 9% with an average of 93.4% (n=142; N=152) of patients with pain intensity less than moderate pain, while in September after omitting quarter three due to Covid-19 surge, all eight surgical wards achieved an average of 88% (n=152; N=173), thus improved by 3,6% compared to the results of November 2019. The average pretest pain knowledge assessment survey taken in January 2020 by 103 surgical nurses in all eight surgical wards was 71%. In October 2020, 114 surgical nurses participated in the post-test and achieved 83%, demonstrated an increase of more than 12% from all 20 questions. Conclusion: The eight surgical wards substantially achieved more than 80% of patients with controlled postsurgical pain levels of less than moderate pain during the last two prevalence cycles, and the posttest revealed pain management knowledge acquisition from the baseline of the pretest conducted. It is therefore postulated that it is essential to monitor the pain management quality of delivered patient nursing care interventions based on the type of pain and consider the provision of refresher training sessions to influence practical skills of pain management competencies.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Optimizing Post-Surgical Pain Management in Adult Surgical Patients: Effects of Training Interventions on Surgical Nurses’ Knowledge
    AU  - Nabeeha Tashkandi
    AU  - Laura Taylor
    AU  - Litaba Efraim Kolobe
    AU  - Sharon Chellan
    AU  - Loh Cheng Cheng
    Y1  - 2022/04/14
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ajns.20221102.14
    DO  - 10.11648/j.ajns.20221102.14
    T2  - American Journal of Nursing Science
    JF  - American Journal of Nursing Science
    JO  - American Journal of Nursing Science
    SP  - 70
    EP  - 76
    PB  - Science Publishing Group
    SN  - 2328-5753
    UR  - https://doi.org/10.11648/j.ajns.20221102.14
    AB  - Context: There is a surplus of contemporary scientific evidence-based indicated numerous precarious positions with inadequate post-surgical pain management in adult surgical patients. The most important barrier in this context was suboptimal postsurgical pain interventions. Aim: This nursing improvement initiative aimed to optimize post-surgical pain nursing interventions in adult surgical patients by training surgical nurses the strategies to enhance their pain management competencies in one teaching hospital in Saudi Arabia. Materials and methods: A descriptive, cross-sectional pain prevalence survey was conducted quarterly in all eight adult surgical inpatients wards to determine and assess if their pain was controlled to a satisfactory level of less than moderate pain. Secondly, pre-and post-test surgical nurses’ knowledge assessment surveys were conducted. Descriptive statistics were used to analyze and interpret and present the data. Results: The outcomes demonstrated that through the improvement nursing initiative strategies implemented, the pain prevalence survey in February 2020 improved by more than 9% with an average of 93.4% (n=142; N=152) of patients with pain intensity less than moderate pain, while in September after omitting quarter three due to Covid-19 surge, all eight surgical wards achieved an average of 88% (n=152; N=173), thus improved by 3,6% compared to the results of November 2019. The average pretest pain knowledge assessment survey taken in January 2020 by 103 surgical nurses in all eight surgical wards was 71%. In October 2020, 114 surgical nurses participated in the post-test and achieved 83%, demonstrated an increase of more than 12% from all 20 questions. Conclusion: The eight surgical wards substantially achieved more than 80% of patients with controlled postsurgical pain levels of less than moderate pain during the last two prevalence cycles, and the posttest revealed pain management knowledge acquisition from the baseline of the pretest conducted. It is therefore postulated that it is essential to monitor the pain management quality of delivered patient nursing care interventions based on the type of pain and consider the provision of refresher training sessions to influence practical skills of pain management competencies.
    VL  - 11
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Nursing Administration, King Abdulaziz Medical City Hospital, Riyadh, Saudi Arabia

  • Nursing Surgical Care and Business Center, King Abdulaziz Medical City Hospital, Riyadh, Saudi Arabia

  • Nursing Pain Management, King Abdulaziz Medical City Hospital, Riyadh, Saudi Arabia

  • Nursing Surgical Care and Business Center, King Abdulaziz Medical City Hospital, Riyadh, Saudi Arabia

  • Nursing Surgical Care and Business Center, King Abdulaziz Medical City Hospital, Riyadh, Saudi Arabia

  • Sections