POSTOPERATIVE PAIN IN CHILDREN - COMBINING AUDIT AND A CLINICAL NURSESPECIALIST TO IMPROVE MANAGEMENT

An audit project was designed to assess and improve the provision of p ostoperative analgesia in a children's hospital. Pain assessment for a ll children and analgesia standards for our institution were introduce d prior to data collection. Data were collected on consecutive samples of 316 and 325 children undergoing surgery as inpatients during 10-we ek periods. Change was initiated between the two periods in response t o our findings; our action plan involved education, changes to documen tation, the widespread use of diclofenac in children over 2 years of a ge and recommendations for the prescription of analgesia. The initial prescription of analgesia increased from 95% to 98% (p = 0.019), admin istration of analgesia to children experiencing bad or severe pain inc reased from 57% to 71% (p = 0.032) and the number of children experien cing severe pain reduced from 17% to 11% (p = 0.050). Application of a udit, by a clinical nurse specialist, enabled us to achieve and demons trate improvements in the prescription, administration and effectivene ss of postoperative analgesia.