A comparison of pain assessment following cesarean section between ward nurse and pain management team in Siriraj Hospital

Abstract

Background: Effective post-cesarean section pain control is important to provide opportunities for breast-feeding, mother-child bonding, early ambulation and discharge that leading to greater overall patient’s satisfaction. Nurses play an important role in postoperative pain management. Effective pain management depends on accuracy, validity and reliability of pain assessment.

Objective: Comparing pain assessment in post-cerasean section patients between ward nurses and pain management team in Siriraj Hospital.

Methods: 1,363 parturients who underwent cesarean section in Siriraj Hospital from August 2012 to January 2013 were enrolled. The ward nurses and pain management team assessed post-cesarean section pain score by using verbal numericrating scale. The ward nurses assessed pain score at 6, 12 and 24 hours postoperatively while the pain management team assessed rest pain and pain on movement at 24 hours postoperatively.

Results: Mean pain score was assessed by ward nurse at 6,12 and 24 hour were 2.2±2.0, 2.9±1.9 and 2.9±1.8,respectively while by pain management team at 24 hour at rest
and on movement were 1.8±1.8 and 4.4±2.1, respectively (p<0.001).

Conclusion: Pain assessment by ward nurse was significantly lower than by pain management team. 30-40% of patients had ineffective pain control. The pain on movement was significantly higher than at rest. Pain on movement should be evaluated rather than rest pain. Accuracy of pain evaluation is the key for improving quality of post-cesarean section pain control.