Pain assessment and management in different wards of a tertiary care hospital

Objective: To assess the pain management by medical team, emergency room (ER) team and Acute Pain team in a tertiary care hospital. Methods: The cross-sectional study was done in Medical Ward, Surgical Ward and Emergency Room of Aga Khan University, Karachi, in March-April 2010. The assigned research medical officer visited the three locations every day and selected patients by way of convenient sampling. The study comprised 75 patients; 25 each in three groups. Information was collected on patient's demographics, general characteristics, type of drugs and modalities used. Specific queries about pain were sorted out like adequacy of pain assessment done by primary physician, pain intensity, any intervention done and pain relief post-intervention. SPSS version 17, analysis of variance and Chi square test were used for statistical purpose. Results: The mean current pain score on the visual analogue score (VAS) was lowest in the Surgical Ward which was being managed by the Acute Pain Management Service (APMS) team followed by the Medical Ward and then Emergency Rooms. The difference was found to be statistically significant. The mean of worst pain score was also the lowest in the Surgical Ward. There was significant difference between wards in terms of the use of pain medications. Proper documentation for pain was done for all patients in the Surgical Ward, followed by the Emergency Room and then the Medical Ward. Conclusion: Better pain assessment, re-assessment, documentation and patient satisfaction were observed in the Surgical Ward compared to the other two locations of the study.