Abstract

POST-OPERATIVE PAIN ASSESSMENT, MANAGEMENT COMPLIANCE WITH WHO GUIDELINES, AND BARRIERS IN HOSPITALS

Vishma K., Radhesh Hedge, Adarsh Sudeendran, Poornachandra Thejeswi DS and Reshmina Chandni Clara Dsouza*

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Abstract

Background: The study aimed to assess the documentation of pain assessment, compliance with WHO guidelines for pain management, and identify barriers to effective pain management in post-surgical patients in two private hospitals in Ethiopia. A cross-sectional retrospective study design incorporating quantitative and qualitative methods was used. Materials: The study utilized a cross-sectional retrospective design, combining quantitative and qualitative methods, to assess pain assessment documentation, compliance with WHO guidelines for pain management, and barriers to effective pain management in post-surgical patients. The study included a review of 730 patient records from two private hospitals in Mangalore. The WHO guidelines were used to review patient records, and key informants were interviewed using a semi-structured questionnaire. Descriptive statistics, such as texts, tables, and graphs, were used to present the results. SPSS-23 software was employed for data analysis, and thematic analysis was conducted for the qualitative data obtained from the key informants. Results: A total of 730 patient records were reviewed, and it was found that pain assessment within 48 hours after surgery was documented for only 51.8% of cases. Furthermore, the location of pain was explained in 25.5% of cases, pain quality was assessed in 35.1% of cases, and a pain intensity tool was used in 46.3% of cases. The most commonly prescribed medications for pain management were weak opioids (tramadol) and non-steroidal anti-inflammatory drugs. Side effects were poorly documented, with only 4.4% of patient cards indicating side effects, primarily nausea and vomiting. Barriers to effective pain management included a lack of regular clinical audits, insufficient technical updates on pain assessment and management, and healthcare professionals' knowledge and attitude towards pain management. Additionally, the study highlighted a lack of regulation in procuring anti-pain medications. Conclusion and Recommendation: The study found that pain assessment and documentation were suboptimal compared to previous studies. To improve pain management, the researchers recommended regular technical updates for healthcare professionals, frequent clinical audits on pain management practices, and the establishment of a mechanism to ensure the easy availability of anti-pain medications, particularly strong opioids.

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