Using mobile technology to enhance acute pain management in post-operative surgical patients in the hospital and and community setting. (part time) Ref: RIHSC-CH-2014-2-PhD
This project will explore the role played by mobile technology to support decision making around the management of acute pain management, in patients who are treated under an accelerated discharge programme, from hospital admission to community home care, following discharge.
PROJECT AIMS AND OBJECTIVES
Pain management for patients in hospital continues to be a problem despite the presence of Acute Pain Services (APS), effective pain relief techniques and drugs, and the availability of evidence-based protocols and guidelines.
Severe pain continues to occur in up to 40% of patients after surgery.
There are two main contributory elements to this problem.
Firstly the difficulties faced by junior doctors, moving between hospitals in sourcing accurate protocol-specific acute pain management information especially ‘out of hours’ to support their treatment focused decision making which can compromise effective and efficient acute pain management in the hospital setting.
Secondly, the fact that pain management is less than optimal for patients in the transition from hospital to home.
The reasons for this last failure are multiple; patients might think that severe pain is a normal part of recovery, or not know whom to contact for advice.
Changes in surgical services mean that patients spend limited time in hospital and must manage treatment at home; so it is important that we provide better communication, better monitoring of symptoms and timely link to clinical support via the use of mobile technology.
Whilst there are a significant number of apps on the market, they almost exclusively focus upon chronic pain management (a very different phenomenon), the use of mobile technology in acute pain management is a new direction of care.
Thus, this two stage project seeks to address two major flaws in acute pain management via the following objectives
To explore the information needs of junior doctors managing pain ‘out of hours’ in institutions with differing procedures and protocols via focus groups
To develop or identify a platform agnostic app that will accommodate these needs in line with specific hospital protocols
To test the effectiveness of this app in terms of effective pain management and informed doctors.
Outcome measures – frequency and patterns of App use, number of referrals to the Acute Pain Service.
Determine the feasibility of using smart phone or tablet technology to measure pain scores and side effects for patients undergoing planned abdominal surgery.
To evaluate whether readmission rates (for poor pain control at home) changed significantly from baseline
To evaluate the acceptability of this approach from the point of view of the patients and acute pain services
Outcome measures – pain, nausea, complications, HRQoL activity, self-referrals to pain team
The study will collect both quantitative and qualitative data including pain scores, referral rates HRQoL scores together with focus groups and interviews where appropriate
SPECIFIC REQUIREMENTS OF THE PROJECT
The successful applicant for this project will be a registered nurse with experience of caring for patients in the surgical setting.
Ideally, they will have experience in the management of acute pain in post-operative patients.
Good communication skills are essential.
A minimum of a first degree (2.1 or above) is essential and a Master’s level qualification in an associated subject is desirable.
The ability to work on one’s own initiative will be an advantage as will experience of participating in research or audit related activities other than those required for degree completion.
The successful applicant will have an easily detectable digital footprint, be used to using social media and have an appreciation of how mobile technology can be used to support health care.
Please quote the studentship reference number RIHSC-CH-2014-2-PhD.
This project will require ethical approval via the NRES system and the successful applicant will be expected to contribute to the application process with support.
Access and participation
Access to junior doctors who would be invited to participate in Stage 1 if this study is successful has been negotiated with the Associate Director of Medical Education for the Northwest.
The technical brief for the Stage 1 app has been written.
For stage 2, access to a Northwest NHS trust has been negotiated and the appropriate gatekeepers have been identified and have expressed a commitment to this study.
A suitable app has been identified to support patients and acute pain service delivery which will communicate between patient and support team
There is the potential that improved decision making at the bedside and increased support for patients once discharged will improve the management of pain and reduce the associated costs of longer hospital stay, admission to a high dependency unit, chronic pain, and stress to patients.
This project is suitable for part-time students.