Management of Acute Pain in the Emergency Department

Study Overview
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Brief Summary
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Oligoanalgesia1 has been widely recognized as an issue in emergency department.The purpose of our study is to assess the impact of the implementation of a computer-assisted support program to improve pain management in our ED.

Detailed Description
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Inadequate pain management remains a major challenge for health care providers. Despite extensive research on the mechanisms of acute pain, identification of factors leading to poor pain management and development of evidence-based strategies, the transfer of this knowledge into effective clinical practices has been surprisingly slow. Oligoanalgesia1 has been widely recognized as an issue in emergency department (ED) patients. Acute pain is reported by 60-80% of ED inpatients but is frequently undertreated. Overall, an insufficient proportion of patients with acute pain receive any type of analgesia, and pain relief remains unsatisfactory. We showed that the implementation of guidelines improved pain management. However, rotation of the medical & nursing staff leads to the forgetting of guidelines. The purpose of our study is to assess the impact of the implementation of a computer-assisted support program to improve pain management in our ED.

Official Title
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Management of Acute Pain in the Emergency Department:Impact of a Computer-Assisted Support

Conditions
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Pain

Intervention / Treatment
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* Device: computer-assisted decision support


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any patient admitted to our Emergency Department who is age > 16 years pain lasting =< 1 week or no pain on admission but pain during the ED stay Exclusion Criteria: life-threatening condition requiring immediate admission in the OR or ICU no pain or pain lasting >1 week inability to give informed consent (intoxicated, psychiatric disorder, language problem, prisoner)

Ages Eligible for Study
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Minimum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 1<br>Pre-intervention patients admitted to our ED in the month prior to the intervention, before the 'computer-assisted decision support' is turned on (the intervention) | |
| 2<br>Short-term post-intervention cohort of patients admitted in the month following the initiation of the 'computer-assisted decision support' for pain management | Device: computer-assisted decision support<br>* at the end of the pre-intervention period, the patient flow software was modified to open popup windows automatically when pain intensity was not documented or pain was not reevaluated within the recommended interval. The popup window also detailed appropriate pain treatment guidelines based on the documented pain intensity. In addition, the patient's icon in the flow software changed from black to red when pain intensity was >4/10. After a 10-day test period, the post-intervention data collection started.<br>* Other names: information technology;|
| 3<br>long-term post-intervention cohort of patients admitted on the 6th month following the initiation of the 'computer-assisted decision support' for pain management | Device: computer-assisted decision support<br>* at the end of the pre-intervention period, the patient flow software was modified to open popup windows automatically when pain intensity was not documented or pain was not reevaluated within the recommended interval. The popup window also detailed appropriate pain treatment guidelines based on the documented pain intensity. In addition, the patient's icon in the flow software changed from black to red when pain intensity was >4/10. After a 10-day test period, the post-intervention data collection started.<br>* Other names: information technology;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pain, Pain Measurement, Decision Making, Computer-Assisted, Informatics