Issn Print: 1098-7339

Publication Date: 2008/09/01


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Patient or Nurse - Controlled Analgesia?: 160

O. Shamay-Rosler; A. Grinfeld; A. Perel; Z. Behar; A. Shamis; I. Gur-Arieh

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Author Information: Sheba Medical Center, Pain Management Unit, Department of Anesthesiology, Ramat Gan, Israel

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Background: The APS (Acute Pain Service) at The Sheba Medical Center like most of the institutions in Israel and the world over, is under the auspices of their respective Depts of Anesthesia; who set policy, staff, supply and maintain equipment, and are generally directly responsible for all aspects of patient care.. Beyond the obvious alleviation of pain and reduction of hurt and suffering, a major benefit can be measured in economic outcomes: A drop in morbidity, reduction in overall length of hospitalization, and lowering patient recidivison.
Aims and Methods: Two years ago, due to the anesthesiologist's inability to provide for the increase in demand, our institution dramatically restructured the in-house acute pain management paradigm. Individual surgical wards were given autonomy in the day to day pain management of most patients. The APS, while continuing to care for specific difficult referrals, became an umbrella consultant service, responsible for supervision, instruction, counseling, and inspection of the ward staff who now took over all aspects of the pain patients care.
Results: The results of this program clearly show, that safe and efficient acute pain treatment can and should be integrated to the duties of the nursing staff in the ward; it is the bedside nurse whose ordinarily duties require constant vigilance in attending to the patient's needs that makes them exquisitely qualified to identify and treat most patient's common acute pain needs.
Conclusions: This model promotes development of heightened performance at the nursing staff level, and improves the quality and welfare of the patient.

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