+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Audit improves emergency department triage, assessment, multi-modal analgesia and nerve block use in the management of pain in older people with neck of femur fracture



Audit improves emergency department triage, assessment, multi-modal analgesia and nerve block use in the management of pain in older people with neck of femur fracture



Australasian Emergency Nursing Journal 17(4): 176-183



The use of NBs as a mode of analgesia for #NOF in the ED is not common practice despite the reported clinical benefits of quicker onset of pain relief, decreased use of additional analgesia and decreased amounts of analgesia required when more than one mode of analgesia is prescribed. This study aims to test the hypothesis that the implementation of educational and awareness strategies increases knowledge, and implementation of the evidence based use of nerve blocks NB's, as a mode of analgesia for elderly patients with a fractured neck of femur (#NOF) in the Emergency Department (ED). A retrospective clinical audit of medical records using explicit chart review pre and post implementation. Implementation of educational and awareness strategies on pain management to clinical staff in the ED resulted in a significant increase in the administration of NBs, use of multimodal analgesia, and a reduction in average milligrams of morphine administrated to elderly patients with #NOF. The number of older people with #NOF presenting to the ED in Australia is increasing and historically, pain management in this group of patients could be improved. This study demonstrated that an audit, intervention and re-audit design that focused on the implementation of educational and promotional strategies informed by evidence on current and best practice standards were successful in improving delivery of analgesia to elderly patients with #NOF in the ED.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 051714803

Download citation: RISBibTeXText

PMID: 25151180

DOI: 10.1016/j.aenj.2014.06.001


Related references

Three-in-one femoral nerve block as analgesia for fractured neck of femur in the emergency department: a randomized, controlled trial. Annals of Emergency Medicine 41(2): 227-233, 2003

Emergency department use of a continuous femoral nerve block for pain relief for fractured femur in children. Emergency Medicine Journal 24(2): 113-114, 2007

Femoral nerve block for acute pain relief in fracture shaft femur in an emergency ward. Saudi Journal of Anaesthesia 9(4): 439-441, 2015

Multi-modal-analgesia for pain management after Hallux Valgus surgery: a prospective randomised study on the effect of ankle block. Journal of Orthopaedic Surgery and Research 2: 26, 2007

Single fascia iliaca compartment block for pain relief in patients with fractured neck of femur in the emergency department: a pilot study. European Journal of Emergency Medicine 18(6): 340-343, 2011

Audit of chest pain triage in the Emergency Department. European Heart Journal 19(ABST Suppl. ): 292, 1998

Fascia iliaca compartment nerve block versus systemic pain control for acute femur fractures in the pediatric emergency department. Pediatric Emergency Care 30(7): 469-473, 2014

A prospective, double-blinded, randomized comparison of ultrasound-guided femoral nerve block with lateral femoral cutaneous nerve block versus standard anesthetic management for pain control during and after traumatic femur fracture repair in the pediatric population. Journal of Pain Research 10: 2177-2182, 2017

Introduction of a paediatric pain management protocol improves assessment and management of pain in children in the emergency department. Archives of Disease in Childhood 92(9): 828-829, 2007

A standardized pain management protocol improves timeliness of analgesia among emergency department patients with renal colic. Quality Management in Health Care 20(1): 30-36, 2011

A triage algorithm for the rapid clinical assessment and management of emergency department patients presenting with chest pain. Critical Pathways in Cardiology 3(3): 154-157, 2004

Use of Femoral Nerve Blocks to Manage Hip Fracture Pain among Older Adults in the Emergency Department: A Systematic Review. Cjem 18(4): 245-252, 2016

The effect of emergency department crowding on the management of pain in older adults with hip fracture. Journal of the American Geriatrics Society 54(2): 270-275, 2006

Ultrasound guided femoral nerve block: An essential pain management modality in emergency settings for femur fractures. Saudi Journal of Anaesthesia 4(2): 118-119, 2010

An audit on assessment and management of pain at the time of acute hospital admission in older people. International Journal of Clinical Practice 64(10): 1453-1457, 2010