Centre for Quality and Patient Safety Research
Faculty of Health
221 Burwood Highway
Burwood Vic 3125
Quality and Patient Safety
Translations of evidence into pain management
Translations of evidence into pain management
The problem of uncontrolled postoperative pain is well documented. Worldwide prevalence studies have shown up to 80% of patients experience significant pain after surgery and they receive less than 50% of the analgesics they are prescribed. Similar Australian studies have shown that over 40% of patients experience unnecessary pain after surgery. Ineffective pain management has severe moral, political and financial implications for health. In particular, poorly managed postoperative pain is linked to suboptimal quality of care processes and can pose serious risks for patients’ safety, as well as having a negative impact on patients’ general functioning and wellbeing. Effective use of analgesics offers significant health benefits and is associated with positive outcomes for both patients and healthcare organisations. Given the significant benefits of effective pain management and the potential consequences of poor analgesic control, it is imperative that current practices become consistent with guidelines developed from the best available scientific evidence.
In 2010 Professor Mari Botti and her team were awarded an ARC Development grant to collate the best available evidence to inform the development of standard care processes to address the problem of ineffective pain management in postoperative care. To progress this innovative study the investigators have partnered with clinicians involved in medication prescribing, pain assessment and clinical management to address the complex problem of postoperative pain management through two fundamental components:
Evidence shows that interventions to improve postoperative pain management often fail because they are not sustained in the clinical environment once the initial implementation period is over. To avoid this problem, the Promoting Action on Research Implementation in Health Services (PARiHS) framework will be used to guide the clinical implementation of the MAPP, as it has been successfully used previously in improving postoperative pain management. The intervention will be tested in three sites across public and private hospitals to assess applicability in different healthcare contexts.
This project has potential economic and social benefits for Australia through improving care processes related to the management of postoperative pain, therefore minimising the adverse outcomes associated with unrelieved pain. The project will provide guidance for the formulation of educational programs and practice protocols and will inform policy development locally, nationally and internationally.
The research team includes: Prof Mari Botti, Prof Tracey Bucknall, Prof Maxine Duke, Prof Megan-Jane Johnstone, Prof Bridie Kent, Dr Rosemary Watts, Richard Steiger, Dr Bernice Redley, Julie Considine
‘Listen to me, I really am sick!’ Understanding patient perspectives in triggering responses to medical emergencies
Patients entering hospital expect that the care they receive is safe and unlikely to cause harm. Yet hospital systems may fail deteriorating patients, with detailed descriptions of suboptimal care requiring patient admissions to intensive care and high rates of serious adverse events (SAEs) resulting in death and severe disability. Many SAEs that occur in hospitals are often preceded by warning signs that are not always acted upon. Significant research has focused on the clinician detecting and responding to patient deterioration. However there has been no research that explores the patient’s perspective and role in initiating clinician and service responses to critical illness. A recent priority in healthcare is to improve the safety and quality of health care by placing patients at the centre of care; by providing respect for, and response to, patient preferences, needs and immediate treatment requirements.
The first reported ZUMBA GOLD dialysis programPeople requiring dialysis three times per week have only limited exercise leading to muscle deconditioning, a reduced quality of life and increased risk of injury. Low-impact exercise programs during dialysis have been found to be safe and beneficial for this group. Exercise can alleviate the boredom of receiving dialysis, creating an exercise-focused positive environment in the dialysis centre. A popular exercise program designed for people with physical limitations and inactive older people is Zumba Gold®. This is a program in which the Latin and international dance rhythms created in the original Zumba® program are adapted for older populations.
This project explored the feasibility of implementing a modified Zumba Gold program for patients in Moorabbin Dialysis Centre. Twenty, 30-minute sessions were completed in the unit over a two week period. Choreographed to music the exercises included various shoulder, arm, and leg movements, including shoulder squeezes, arm lifts, knee lifts and toe taps. Participants became increasingly active and engaged as the sessions progressed, and the instructor adjusted movements accordingly. Several staff and other dialysis patients spontaneously participated in the exercises.