Documenting and implementing evidence-based post-operative pain management in older patients with hip fractures

Summary 

This study describes the type of pain assessment and management received by post-operative patients aged 65 years and over with a hip fracture. A retrospective audit of patients’ medical records for the first five post-operative days was used. Forty-three medical records were audited at a large metropolitan hospital in Australia. Charts were eligible for auditing if the patient had a hip fracture surgically repaired and was over 65 years old.

The documentation showed that nurses infrequently assessed pain and rarely used pain assessment tools. Pain interventions were pharmacological, with the most frequently administered analgesics being paracetamol (61.4%) and morphine (8.0%). Non-pharmacological interventions nor pain management education were documented. The findings of this study were similar to previous studies using other populations. It reinforced that nurses’ documentation of pain assessment and management was insufficient and failed to contribute to continuity of care. It is recommended that a greater focus on acute pain is required by organizations if pain management is to improve. Feedback to nurses on their practice provides a starting point for practice development.

Keywords: Post-operative pain, Pain assessment, Pain management, Older adult, Documentation, Evidence-based practice, Hip fracture