20. Statistical process control as a tool for improvement in an acute Pain Service (399)

Fiona Duncan, Nurse Specialist. Visiting Research Fellow, Salford Centre for Nursing, Midwifery and Collaborative Research, University of Salford, Greater Manchester, United Kingdom
fmduncan@orange.net

Abstract:

Postoperative pain management, although much improved in the past decade, remains suboptimal despite the availability of effective pain control drugs and techniques. There is a paucity of robust evidence to support the impact of Acute Pain Services (APS). Pain management is a complex topic; effective delivery is dependent upon many factors. Randomized trials are not always appropriate or cost effective for learning how to improve care in real clinical settings. Statistical process control (SPC) is a branch of statistics that combines rigorous time series analysis with data presented in graph form. Application of SPC has the potential to improve delivery of effective postoperative pain management. The aim of this study is to demonstrate the use of SPC methods as a tool to improve the patients' pain experience in an established APS. Baseline data has been collected on all major surgical patients nursed with an epidural for postoperative pain control starting January 2006. Data has been presented to a Multidisciplinary Team (MDT) using SPC methods. The interventions initiated by the MDT have been deliberate attempts to introduce ‘special causes’ of variation in the data such as interventions to lower the percentage of patients in severe pain in the first 24 hours after surgery. This research is currently at the stage of comparing the new process with the baseline data. All data has been entered and analysed using Statistical Package for the Social Sciences (SPSS). The results of this prospective study will be presented. Application of SPC methods offer the potential to learn more about both the process of change and outcomes in an APS or any other specialist service and will also signpost fruitful directions for further research in service efficiency.

Biography:

Fiona Duncan qualified as a nurse from Edinburgh Royal Infirmary in 1978 and specialised in intensive care. She then entered hospice nursing working in the U.K. and abroad. Since 1994 she has been an acute pain nurse. She currently combines this clinical post with study at Salford University and is in her 3rd year as a bursaried PhD student. Her current research interests are the effectiveness of postoperative epidural analgesia, and the role of computer technology to assess acute pain treatment modalities.