Management of Acute Pain in the Emergency Department

This study has been completed.
Sponsor:
Collaborator:
Societe Française de Medecine d'urgence
Information provided by:
Centre Hospitalier Universitaire Vaudois
ClinicalTrials.gov Identifier:
NCT00470652
First received: May 4, 2007
Last updated: January 26, 2009
Last verified: January 2009
  Purpose

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.


Condition Intervention
Pain
Device: computer-assisted decision support

Study Type: Observational
Study Design: Time Perspective: Prospective
Official Title: Management of Acute Pain in the Emergency Department:Impact of a Computer-Assisted Support

Further study details as provided by Centre Hospitalier Universitaire Vaudois:

Enrollment: 631
Study Start Date: May 2007
Study Completion Date: September 2008
Groups/Cohorts Assigned Interventions
1
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
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
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.
Other Names:
  • informatics
  • information technology
3
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
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.
Other Names:
  • informatics
  • information technology

Detailed Description:

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.

  Eligibility

Ages Eligible for Study:   16 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population

Consecutive patients discharged from our ED who either had pain on admission or suffered of a new pain while in our ED

Criteria

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)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00470652

Locations
Switzerland
Centre Hospitalier Universitaire Vaudois
Lausanne, Vaud, Switzerland, 1011
Sponsors and Collaborators
Centre Hospitalier Universitaire Vaudois
Societe Française de Medecine d'urgence
Investigators
Principal Investigator: Olivier W Hugli, MD,MPH Centre Hospitalier Universiataire Vaudois
  More Information

Publications:
Responsible Party: Hugli Olivier, MD, MPH, Centre Hospitalier Universitaire Vaudois
ClinicalTrials.gov Identifier: NCT00470652     History of Changes
Other Study ID Numbers: CIU-1
Study First Received: May 4, 2007
Last Updated: January 26, 2009
Health Authority: Switzerland: Laws and standards

Keywords provided by Centre Hospitalier Universitaire Vaudois:
pain
Pain Measurement
Decision Making, Computer-Assisted
Informatics

Additional relevant MeSH terms:
Acute Pain
Pain
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms

ClinicalTrials.gov processed this record on September 16, 2014