The Association between Patients’ Perception of Their Overall Quality of Care and Their Perception of Pain Management in the Prehospital Setting

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American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force.

Judith Paice, Dennis C Turk, Leslie B Gordon … (2005)

The American Pain Society (APS) set out to revise and expand its 1995 Quality Improvement Guidelines for the Treatment of Acute Pain and Cancer Pain and to facilitate improvements in the quality of pain management in all care settings. Eleven multidisciplinary members of the APS with expertise in quality improvement or measurement participated in the update. Five experts from organizations that focus on health care quality reviewed the final recommendations. MEDLINE and Cumulative Index to Nursing and Allied Health Literature databases were searched (1994-2004) to identify articles on pain quality measurement and quality improvement published after the development of the 1995 guidelines. The APS task force revised and expanded recommendations on the basis of the systematic review of published studies. The more than 3000 members of the APS were invited to provide input, and the 5 experts provided additional comments. The task force synthesized reviewers' comments into the final set of recommendations. The recommendations specify that all care settings formulate structured, multilevel systems approaches (sensitive to the type of pain, population served, and setting of care) that ensure prompt recognition and treatment of pain, involvement of patients and families in the pain management plan, improved treatment patterns, regular reassessment and adjustment of the pain management plan as needed, and measurement of processes and outcomes of pain management. Efforts to improve the quality of pain management must move beyond assessment and communication of pain to implementation and evaluation of improvements in pain treatment that are timely, safe, evidence based, and multimodal.

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Factors affecting patient satisfaction and healthcare quality.

Rayapati A Naidu (2008)

The aim of this paper is to build a comprehensive conceptual model to understand and measure variables affecting patient satisfaction-based healthcare quality. A total of 24 articles from international journals were systematically reviewed for factors determining patient satisfaction and healthcare quality. Patient satisfaction is a multi-dimensional healthcare construct affected by many variables. Healthcare quality affects patient satisfaction, which in turn influences positive patient behaviours such as loyalty. Patient satisfaction and healthcare service quality, though difficult to measure, can be operationalized using a multi-disciplinary approach that combines patient inputs as well as expert judgement. The paper develops a conceptual model that needs to be confirmed empirically. Also, most research pertains to developed countries. Findings are presented that may not be generalized to developing nations, which may be quite different culturally. The paper has direct implications for health service providers. They are encouraged to regularly monitor healthcare quality and accordingly initiate service delivery improvements to maintain high levels of patient satisfaction. The paper collates and examines recent healthcare quality study findings. It presents a comprehensive, conceptual model encompassing research work and a holistic view of various aspects affecting patient satisfaction and healthcare quality. Although a large amount of healthcare quality research has been done, each studying a particular service, this paper comprehensively brings together various research findings.

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Prehospital pain management: a comparison of providers' perceptions and practices.

Halim Hennes, Michael Kim, Ronald Pirrallo (2015)

To assess the knowledge of emergency medical technicians-paramedics (EMT-Ps) and compare their practice perceptions with actual pain management interventions in adults and pediatric patients (adolescents and children) with chest pain (CP), extremity injuries, or burns. This study included a cross-sectional survey of EMT-Ps and review of the emergency medical services (EMS) system patient care database. EMT-Ps were surveyed for: 1) knowledge of pain treatment protocol; 2) estimated number of CP, extremity injury, or burn encounters and the frequency of morphine administration; and 3) barriers to providing morphine. Data on patients transported with any above conditions and those who received morphine were abstracted from the EMS patient care database. Data were analyzed using descriptive statistics, and 95% confidence intervals (CIs) were calculated. Of 202 EMT-Ps, 155 (77%) completed the survey. Eighty-two percent reported knowledge of pain treatment protocol for both adults and pediatric patients. For adults, EMT-Ps estimated they administered morphine to 37% with CP (95% CI 35, 40), 24% with extremity injuries (95% CI 17, 30), and 89% with burns (95% CI 52, 99). In children and adolescents, inability to assess pain (93%) was the most common reason for withholding morphine. According to the EMS database, 5% of adults with CP (95% CI 4, 5), 12% extremity injuries (95% CI 8, 15), and 14% burns (95% CI 8, 20) received morphine. In children and adolescents, 3% with extremity injuries (95% CI 1, 5) and 9% with burns (95% CI 0, 26) received morphine. Pain score was documented in 67.0% of adult patients, compared with only 4.0% in pediatric patients (Delta = 63.0%, 95% CI: 60, 65). Significant disparity exists between EMT-Ps' perceptions of acute pain assessment and the frequency of providing analgesia and their actual practice. Children and adolescents had less documentation of pain assessment and received less analgesic interventions compared with adults. Inability to assess pain may be an important barrier to the provision of analgesia.

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Journal

Title: Prehospital Emergency Care

Abbreviated Title: Prehospital Emergency Care

Publisher: Informa UK Limited

ISSN (Print): 1090-3127

ISSN (Electronic): 1545-0066

Publication date Created: March 19 2013

Publication date (Print): April 23 2013

Volume: 17

Issue: 3

Pages: 386-391

Article

DOI: 10.3109/10903127.2013.764948

PubMed ID: 23611142

SO-VID: 09796a2d-bde2-46b3-82cf-bc7f72a5f877

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The Association between Patients’ Perception of Their Overall Quality of Care and Their Perception of Pain Management in the Prehospital Setting

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Most cited references 12

American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force.

Factors affecting patient satisfaction and healthcare quality.

Prehospital pain management: a comparison of providers' perceptions and practices.

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