Pain treatment practice and its impact on patient satisfaction in emergency department: experience from Tikur Anbessa specialized hospital, Ethiopia, 2019.
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Date
2019-08
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Addis Abeba University
Abstract
Background: Undertreatment of pain is common in emergency department. The major reasons
are lack of staff training in recognition, measurement and adequate pain treatment. Despite the
global attention being given over the years, undertreatment of pain in the clinical practice is
still an issue.
Objective: The general objective of this study is to assess the pain treatment practice and its
impact on patient satisfaction in the emergency department of Tikur Anbessa Specialized
Hospital, July 15-19, 2019 Addis Ababa Ethiopia.
Methodology: Single cantered, prospective, observational study for a continuous 24 hours of
5 days was conducted on total of 106 patients with history of recent pain. Numeric Rating Scale
was used to assess patient’s severity of pain. Each patient was evaluated twice, initially at triage
and 2-4 hours after arrival. The desire for analgesics was assessed at triage and Patient’s level
of satisfaction was also assessed during the second evaluation. Data was analysed with SPSS
version 21
Results:
Out of 106 patients male account for 57.5% with M:F ratio of 1.3. The mean age of participants
was 42.53years, with SD =16.3 years. The majority of patients were having medial emergency
followed by oncologic emergency and trauma. The mean initial numeric rating scale was 5.88
(SD=2.09) measured out of 10. The proportion of patients who did not receive analgesics prior
to emergency department were 77.4% (n=82), despite the fact that 57.5% (n=61) of them were
referred by primary care taker. Desire for analgesics was found to be significantly associated
with initial numeric rating scale. Despite the fact that 80.2% (n=85) of the patients desired
analgesia, it was prescribed only for 51%(n=54) patients and actually taken by only
41.5%(n=44). Asking for analgesics and patient presentation during day time were
significantly associated (p<0.05) with physician analgesics prescription.
The overall satisfaction with pain treatment was reported in 68.87% (n=73) patients, despite
the presence of undertreatment in 54% (n=52). Coming at day time and lower repeat numeric
repeat scale has statistically significant association with over all emergency department in
pain treatment satisfaction.
Conclusion: There was a significant undertreatment of pain in the emergency department of
Tikur Anbessa Specialized Hospital. Under recognition of pain by physicians and decision not
to prescribe was the major reason patients didn’t take analgesics. Despite that, patient
satisfaction was good and repeat mean numeric rating scale was also decreased.
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Keywords
TASH, Numeric Rating Scale, Emergency Department, Pain Treatment, Pain satisfaction