Post-operative pain assessment, management compliance with WHO guidelines and its barriers in hospitals of West Shoa zone, central of Ethiopia, 2021.

Abstract

Post-Surgical pain should be consistently assessed and documented as vital signs as well as has to be better communicated and adequately managed accordingly. However, there is a limited study regarding pain assessment and management documentation in Ethiopia. This study aimed to determine pain assessment documentation, pain management compliance with WHO guidelines, and its barrier. A cross-sectional retrospective study design mixed with quantitative and qualitative study types was employed. Three hundred sixty-five Patient cards were reviewed from four public hospitals in the West Shoa zone; Central Ethiopia, as well as four key informants groups, were interviewed. WHO guideline was used to review the patient card and a semi-structured questionnaire was used to interview the key informants. Descriptive statistics were used to describe the socio-demographic characteristics; and pain characteristics, and texts, tables, and graphs were used to present the results. Data were analyzed using SPSS-20 and Data from the key informants was thematically analyzed. From the total of 365 patient cards reviewed, it was observed that only for 189(51.8%) cases pain assessment was done within 48h after Surgery. Out of the patient who had got pain assessment within 48h the location of pain was explained in 93(25.5%) cases, pain quality was assessed in 128(35.1%) cases, and pain intensity tool was used in 169(46.3%) cases. Weak opioid (tramadol) is the most commonly described followed by Non-steroid anti-inflammatory drugs to relieve pain after surgery. Only 16(4.4%), patient card side effect was documented and the most reported side effect was Nausea and vomiting (13(3.6%). Lack of regular clinical audits for pain management, lack of technical updates on pain assessment and management as well as knowledge and attitude of health professionals toward pain management were the major barrier to effective pain management. and recommendation: The pain assessment and documentation in the present study were slightly lower than in previous studies. There was a lack of clinical audit for pain management, a lack of refreshment/technical updates on pain assessment and management, and a lack of regulation of procurement for anti-pain medications. We recommend providing regular technical updates for health professionals and conducting a frequent clinical audit on pain management as well as a designing mechanism for easy availability of anti-paint medications, particularly strong opioids.