Management of Acute Pain in the Emergency Department

Pain Clinical Trial

Official title:

Management of Acute Pain in the Emergency Department:Impact of a Computer-Assisted Support

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00470652
• Other study ID #: CIU-1
• Status: Completed
• Phase: N/A
• First received: May 4, 2007
• Last updated: January 26, 2009
• Start date: May 2007
• Est. completion date: September 2008

Study information

• Verified date: January 2009
• Source: Centre Hospitalier Universitaire Vaudois
• Contact: n/a
• Is FDA regulated: No
• Health authority: Switzerland: Laws and standards
• Study type: Observational

Clinical Trial Summary

Oligoanalgesia1 has been widely recognized as an issue in emergency department.The purpose of our study is to assess the impact of the implementation of a computer-assisted support program to improve pain management in our ED.

Description:

Inadequate pain management remains a major challenge for health care providers. Despite extensive research on the mechanisms of acute pain, identification of factors leading to poor pain management and development of evidence-based strategies, the transfer of this knowledge into effective clinical practices has been surprisingly slow. Oligoanalgesia1 has been widely recognized as an issue in emergency department (ED) patients. Acute pain is reported by 60-80% of ED inpatients but is frequently undertreated. Overall, an insufficient proportion of patients with acute pain receive any type of analgesia, and pain relief remains unsatisfactory. We showed that the implementation of guidelines improved pain management. However, rotation of the medical & nursing staff leads to the forgetting of guidelines. The purpose of our study is to assess the impact of the implementation of a computer-assisted support program to improve pain management in our ED.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 631
• Est. completion date: September 2008
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 16 Years and older

Eligibility

Inclusion Criteria:

Any patient admitted to our Emergency Department who is

• age > 16 years

• pain lasting =< 1 week or

• no pain on admission but pain during the ED stay

Exclusion Criteria:

• life-threatening condition requiring immediate admission in the OR or ICU

• no pain or pain lasting >1 week

• inability to give informed consent (intoxicated, psychiatric disorder, language problem, prisoner)

Study Design

Time Perspective: Prospective

Related Conditions & MeSH terms

• Acute Pain
• Pain

Intervention

Device:
• computer-assisted decision support
at the end of the pre-intervention period, the patient flow software was modified to open popup windows automatically when pain intensity was not documented or pain was not reevaluated within the recommended interval. The popup window also detailed appropriate pain treatment guidelines based on the documented pain intensity. In addition, the patient's icon in the flow software changed from black to red when pain intensity was >4/10. After a 10-day test period, the post-intervention data collection started.

Locations

Country	Name	City	State
Switzerland	Centre Hospitalier Universitaire Vaudois	Lausanne	Vaud

Sponsors (2)

Lead Sponsor	Collaborator
Centre Hospitalier Universitaire Vaudois	Societe Française de Medecine d'urgence

Country where clinical trial is conducted

Switzerland, 

References & Publications (1)

Decosterd I, Hugli O, Tamchès E, Blanc C, Mouhsine E, Givel JC, Yersin B, Buclin T. Oligoanalgesia in the emergency department: short-term beneficial effects of an education program on acute pain. Ann Emerg Med. 2007 Oct;50(4):462-71. Epub 2007 Apr 18. — View Citation