Valoración de la actividad de una Unidad de Dolor Agudo Postoperatorio por los cuidadores del paciente quirúrgico

摘要

Objective: An Acute Postoperative Pain Unit (APPU) staffed by nurses and supervised by the Service of Anesthesiology was created in our center in 2.000. The aim of this study was to assess how the staff taking care of surgical patients perceive its activity. Material and method: The Service of Anesthesiology and Resuscitation and the Post-Anesthetic Recovery Unit (PARU) maintain an APPU staffed by nurses that provides planned and protocolized management of postoperative pain to more than 1.000 patients/year undergoing the most aggressive and painful surgical procedures in a second-level hospital. Nurses and doctors taking care of the patients were requested to anonymously and voluntarily answer a written questionnaire with 15 questions (12 close-ended questions grouped in 4 categories and 3 open-ended questions) that assessed several aspects of their activity. Results: Out of 168 questionnaires handed out, 87 questionnaires returned were considered (52%), 48 from doctors and 39 from nurses. The role of the APPU was well or very well understood by 97% of the responders and its activity was perceived rather unanimously as useful, effective and necessary by 98, 93 and 97%, respectively. Treatment indications were considered appropriate or very appropriate by 87%, staff attitude towards consultation was considered satisfactory or very satisfactory by 90% and analgesic techniques were sufficiently understood by 89%. A 67% considered that patients were well or very well informed. Doctors and nurses disagreed in their perception of the degree to which the APPU activity complemented that of other health care staff (low or very low for 51% of nurses versus 19% of doctors; p=0.001) and in the fluency of communication with the staff (little or very little for 41% of nurses versus 19% of doctors; p=0.01). The most valued aspect of the UPPA was the management of postoperative pain; the least valued aspect was the communication between professionals and the most frequent suggestion: attempt to improve such communication. Conclusions: The role of the UPPA is very well understood in our hospital by the staff taking care of surgical patients and while its activity is unanimously perceived as useful and necessary, there are integration and communication problems, specially with the general nursing staff. The identification of this type of situations through opinion polls about its activity can be useful in order to improve the operation of acute pain units with organizational models similar to ours.