Less intelligent patients can also use PCA effectively, but the training load on the nursing and medical staff is larger. In some cases, especially when there is a language barrier, patients may not find PCA to help them because of a poor understanding of the PCA concept. Not infrequently, patients also have difficulties in using the PCA machine because they do not know if they are eligible for a drug dose. Return to Index Bureaucratic Impact Implementation of a PCA program in a hospital is sometimes far from effortless. First, nurses are often poorly trained in entering PCA prescriptions into the pump, either because of limited time and resources for training or because nurses may not have had to care for many patients on PCA pumps in recent weeks.
Mechanical problems can also occur.
While much effort has gone into making PCA safer, much remains to be done. Return to Index Conclusions PCA is a new means of acute pain control with very impressive clinical effectiveness. However, there are a great many unexpored issues related to it its clinical implementation in a hospital setting, especially as it relates to cost-effectiveness, training and safety. Also, much work needs to be done to establish clinical usage guidelines appropriate to contemporary Canadian realities. Little delay between requesting and getting the drug.