Reflections on the Evaluation of the Clinical Practice Guideline Regarding Pain Management and Patient Satisfaction with Total Hip Arthroplasty

Abstract

Introduction: This paper is based on the third Edition of the RNAO "Pain Assessment and Management" guideline applied to total hip arthroplasty (THA) patients and the evaluation of clinical practice guidelines on pain management and patient satisfaction. Objective: To apply the Third Edition Guideline for the Pain Assessment and Management from RNAO to patients after total hip arthroplasty and evaluate its effectiveness. Division of topics covered Evaluate the knowledge, assessment of pain by nursing, and satisfaction in the care of patients with total hip arthroplasty before and after the implementation of the guide, according to the Knowledge to Action Framework. According to 20 recommendations from the Guideline, 6 quality review indicators were formulated: 1. Establish and implement standard assessment processes and forms; 2. Conduct nurse training and patient education; 3. Compare nurses' pain knowledge and attitude levels before and after evidence-based practice; 4. Compare nurses' implementation of various indicators of patient pain assessment and management; 5. Compare pain control satisfaction of total hip arthroplasty patients before and after Best Practice Guideline implementation; and 6. Ensure nurses use the same proven tool to assess pain in patients. Results. After implementing the Guideline, the rate of nurses' knowledge of pain assessment and management has increased from 42.6% to 48%. Nurses' pain screening and evaluation, strategies to encourage patients and if the families participated in pain management were recorded after an assessment, and they were statistically significant (all P<0.05). There were statistically significant differences in patients' perceptions of pain management, active reporting of pain, and patient satisfaction with pain control (all P<0.05). Conclusion: The application of the evidence can improve nurses' knowledge and attitude toward pain assessment and management, standardize their operating system and process, and improve patients' satisfaction with pain control.