Démarche assurance-qualité pour la prise en charge des douleurs postopératoires : proposition d’un outil de réalisation d’enquêtes

Abstract

Objectives: This study presents a tool including survey questionnaires and a specific data-processing software for the data processing, allowing health care providers to assess the quality of postoperative pain management in surgical wards. Study design: Descriptive study. Methods: A committee including anesthesiologists, nurses and epidemiologists had elaborated and tested three survey questionnaires to assess patients, nurses and medical staff satisfaction respectively. Specific data processing software was issued out of the final questionnaires. It allowed a quick analysis of items possibly, explaining inadequate postoperative pain management. After this adjustment, this tool was used in three different surgical wards, named A, B, C. Results: The rate of answer (of investigated persons) being over 50%, data resulting from the survey performed in the surgical wards A and B were considered valid. The items which could explain insufficient pain relief were classified into 4 levels : patients assertion (ex : more than 50% of patients experienced persistent postoperative pain) ; practices evaluation (ex : 42 to 72% health care providers declared being aware of analgesic procedures) ; behavior’s evaluation (ex : 19 to 34% of health care providers considered persistent postoperative pain to be useful for monitoring) ; and surgical wards potential (ex : 21 to 61% of health care providers took a specific course on pain management). Pros and cons of this tool were carefully examined and subsequent strategies defined. Conclusions: This survey’s device should allow health care providers to assess the quality of postoperative pain management in surgical wards. Its validation is currently developed to improve its use, and keep the most performing indicators, showing an adequate postoperative pain management.