Raja Muhammad Mussab
Introduction
Adequate postoperative analgesics are essential in the recovery and rehabilitation
of lower-limb arthroplasty patients via ERAS Protocols. Optimal analgesics
include multimodal analgesics as per NICE Guidelines. In our department,
Inadequate postoperative pain relief lead to increase in post op FU visit, stiffness
and phonecall enquiries. In this study, we assess the effect on Strong Analgesics
in Satisfactory Discharge of Arthroplasty patients
Methods
This QIP was conducted in Arthroplasty Ward, T&O Department in UK DGH. Total
100 patients were included. 50 patients operated in January 2024 were included,
25 had THR and 25 had TKR. The patients were called on 28th day of operation to
evaluate pain score. After Intervention, similar data Collectied of 50 patients from
July 2024 and pain evaluated again at 28 days to evaluate patient satisfaction
after implementing interventional changes.
Results
During the first cycle, analgesic prescription efficiency was 45 percent when
benchmarked to NICE Guidelines and similar were patient satisfaction
percentages. Changes implemented Most importantly were creation of electronic
Arthroplasty Discharge pack that contained adequate analgesics, VTE
Prophylaxis, Laxatives tailored as per patients' need, Secondly SHO teaching and
lastly counterchecking TTO via Nurse incharge. When closing the loop, the
efficiency was increased to 91 % with 89% patient satisfaction.
Conclusion
We have proposed the step ladder pattern of analgesics, in which strong opioids
should be given to aid in pain relief. Additionally, Arthroplasty discharge pack
should be implemented to prevent prescribing errors, and a virtual consultation
by an arthroplasty nurse within one week of operation
Authors
Raja Mussab, Russell Hall Hospital, Dudley, United Kingdom
Prakash Palaparthy, Shehanshah Arqam
Russell Hall Hospital, Dudley, United Kingdom