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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
History of Changes

May 4, 2007
January 26, 2009
May 2007
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Complete list of historical versions of study NCT00470652 on ClinicalTrials.gov Archive Site
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Management of Acute Pain in the Emergency Department
Management of Acute Pain in the Emergency Department:Impact of a Computer-Assisted Support

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.

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.
Observational
Time Perspective: Prospective
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Non-Probability Sample

Consecutive patients discharged from our ED who either had pain on admission or suffered of a new pain while in our ED
Pain
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
  • 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
    Intervention: Device: computer-assisted decision support
  • 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
    Intervention: Device: computer-assisted decision support
Decosterd I, Hugli O, Tamches E, Blanc C, Mouhsine E, Givel JC, Yersin B, Buclin T. Oligoanalgesia in the Emergency Department: Short-Term Beneficial Effects of an Education Program on Acute Pain. Ann Emerg Med. 2007 Apr 17; [Epub ahead of print]

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
631
September 2008
Not Provided

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)
Both
16 Years and older
No
Contact information is only displayed when the study is recruiting subjects
Switzerland
 
NCT00470652
CIU-1
No
Hugli Olivier, MD, MPH, Centre Hospitalier Universitaire Vaudois
Centre Hospitalier Universitaire Vaudois
Societe Française de Medecine d'urgence
Principal Investigator: Olivier W Hugli, MD,MPH Centre Hospitalier Universiataire Vaudois
Centre Hospitalier Universitaire Vaudois
January 2009

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP