Doctor of Nursing Practice (DNP)
Doctor of Nursing Practice (DNP) Program
School of Nursing
Frank Kosnosky, Jr.
PACU, guidelines, medication costs, pain scores, length-of-stay, satisfaction
Purpose: To determine if implementation of revised pain medication administration guidelines in PACU led to improved patient satisfaction scores, lower pain scores at discharge from PACU, lower pain medication and antiemetic medication costs in PACU, and shorter average PACU length-of-stay (LOS) at the clinical site.
Background and Significance: Negative consequences of poorly managed acute postoperative pain include diminished function and quality of life, compromised surgical recovery, extended use of opioids, development of chronic postoperative pain, and increased morbidity and medical costs (Gan, 2017). There is an impetus to minimize narcotic medications administered after surgery, while still providing adequate pain management in the acute postoperative period.
Intervention and Implementation Plan: The revised pain medication administration guidelines were implemented March 1, 2017. The following data points were compared to evaluate impact: PACU LOS, patient satisfaction scores, PACU discharge pain scores, and costs for antiemetics and oral (PO) and IV pain medications. Pre-implementation data includes a three-month sample from 2016. Post-implementation data includes three-month samples in 2017, 2018, 2019, and 2020. PACU nurses were surveyed in January 2021.
Project Outcomes: Patients who received only PO and/or IV pain medications in PACU had: average LOS decrease 8%, IV narcotic costs decrease 5%, analgesic costs decrease 2%, discharge pain scores increase 12%, and antiemetic costs increase 68%. Nurses’ perceptions of the guidelines on their practice and patient outcomes were positive, and patient satisfaction scores were stable.
Keywords: PACU, guidelines, medication costs, pain scores, length-of-stay, satisfaction
Gerber, Elizabeth, "Using Revised Pain Medication Administration Guidelines in Post Anesthesia Care Unit (PACU): A Program Evaluation" (2021). Doctor of Nursing Practice (DNP) Manuscripts. 9.