Is it pain or too much pain medication?

Abstract

<p>Delirium is one of the most common undesirable consequences in older adult surgical&nbsp;patients. Studies have suggested that uncontrolled&nbsp;pain, in addition to overmedicating with opioids,&nbsp;may trigger an episode of&nbsp;delirium.&nbsp;</p> <p><strong>Purpose: </strong>The purpose of this quality improvement project was to improve the acute care orthopedic registered nurses&rsquo; knowledge of delirium and its relationship to uncontrolled pain. It also aimed to evaluate if nurses consulted the pain nurse practitioner, for patients with risk factors for delirium experiencing uncontrolled pain.</p> <p><strong>Design: </strong>Quality Improvement</p> <p><strong>Methods: </strong>Nurses participated in a 30-minute delirium educational session and a pre-test/post-test was used to evaluate their learning. Subsequently, nurses completed Delirium and Uncontrolled Pain Assessment sheets on&nbsp;postoperative total knee replacements, total hip replacements, or open reduction internal fixation patients over age 65.</p> <p><strong>Results: </strong>A paired t-test indicated higher post-test total scores (p &lt; 0.001), compared to pre-test scores. A chi square test for independence indicated a significant association between geriatric patients reporting a pain score &gt;5 and the nurse consulting the pain NP (p &lt; 0.001).&nbsp;</p> <p><strong>Conclusion: </strong>The findings of this project suggest that the delirium educational session increased the knowledge of orthopedic nurses. The results also demonstrated that the nurses applied this content into clinical practice, as evidenced by consulting the pain nurse practitioner for older adult patients at risk for developing delirium and experiencing uncontrolled pain.&nbsp;</p> <p><strong>Clinical Implication: </strong>Brief educational sessions may be effective in improving nurses&rsquo; knowledge of delirium</p>