AHCPR clinical practice guideline on surgical pain management: Adoption and outcomes

Pain management practices and short-term patient outcomes in nine acute car e hospitals in Milwaukee, Wisconsin, were studied at two points in time. On e-and-a-half years after the Agency for Health Care Policy and Research's ( AHCPR) Clinical Practice Guideline on Acute Pain Management was published, data from 330 adult surgical patients were collected (Time I). These data w ere contrasted with data from 373 adult surgical patients collected 2 years later (Time II). There were significant increases in the percentage of pat ients who reported being taught how to report pain using a pain rating scal e and about setting a pain goal preoperatively; in the percentage of patien t hospital records with at least one documented numeric pain rating; and in the percentage of patients who received analgesics by intravenous administ ration. However, pain management practices continued to differ from recomme ndations in the AHCPR guideline. No significant improvement was noted in th e short-term outcomes of patient-rated pain or patient satisfaction with pa in management. Availability of well-published guidelines alone may be insuf ficient to ensure comprehensive adoption of guidelines that are multidimens ional in nature and to obtain improvements in patient outcome. (C) 1999 Joh n Wiley & Sons, Inc.