Auditing your acute pain service—a UK NHS model

Abstract

Abstract This audit has been conducted in order to provide an evidence base that clarifies the strengths and weaknesses of acute pain management at a UK hospital. Consequently, it sets the strategic direction for service improvement. Awarding up to three stars has identified the quality of each component that constitutes the acute pain service. Six different components were audited and star ratings have been awarded as shown below: • Pain tool (including patient and staff understanding): no stars. • Pain team (including education and clinical support): two stars. • Intermittent opioid analgesia (sub-cut and oral morphine): two stars. • Epidural patient controlled analgesia (EPCA): two stars. • Intravenous patient controlled analgesia (IVPCA): two stars. • Single-dose intrathecal opioid analgesia: three stars. These star ratings were pulled together in order to award the acute pain service an overall rating. Consequently, the acute pain service was awarded two stars. The findings of this audit identify that this acute pain service provides a safe way to deliver hi-tech pain relief at ward level and can be relied upon to provide good quality pain management. However, too many patients are likely to miss out on the full benefits of the service due to the weaknesses as identified. The quality of the pain relief is impeded across the hospital due to low patient expectation and poor patient education, and also due to a lack of relevant knowledge amongst nursing staff. Developments in the role of the acute pain nurse, staff training and education programs, and a reduction in the variety of pain management pumps are combining to facilitate the opportunities required to address the weaknesses and to build on the strengths of the acute pain service.