TY - JOUR
T1 - National audit of the quality of pain relief provided in emergency departments in Aotearoa, New Zealand
T2 - The PRiZED 1 Study
AU - The New Zealand Emergency Medicine Network and The Shorter Stays in Emergency Department National Research Project Group
AU - Jones, Peter
AU - Than, Martin
AU - Dalziel, Stuart
AU - Larkin, Gregory Luke
AU - Yates, Kim
AU - MacLean, Alastair
AU - Cheri, Thomas
AU - Munro, Andrew
AU - Brainard, Andy
AU - Joseph, Te Rina
AU - Tauranga, Marama
AU - Quigley, Paul
AU - Peckler, Brad
AU - Makower, Richard
AU - Harvey, Martyn
AU - Watts, Martin
AU - Fleischer, Dominic
AU - Ellis, Craig
AU - Macgregor, Collen
AU - Henry, Jonathan
AU - Schimanski, Karen
AU - Gutenstein, Marc
AU - Colligan, Margaret
AU - Sawtell, Frann
AU - Mitchell, Nancy
AU - Wailing, Joanna
AU - Hussey, Mark
AU - Mcleay, Adam
AU - Cresswell, Chris
AU - Moore, Deborah
AU - Sage, Derek
AU - Ardagh, Michael
AU - Fevre, James Le
AU - McKee, Donald
AU - Harper, Alana
AU - Wells, Susan
AU - Stewart, Joanna
AU - Curtis, Elana
AU - Reid, Papaarangi
AU - Ameratunga, Shanthi
AU - Lagas, Alice
AU - Nienaber, Anna
AU - Shahpuri, Berinder
AU - Lambie, Bruce
AU - McCaffrey, Conrad
AU - Fish, Debra
AU - Ragaban, Faten
AU - Martin, Ian
AU - Taplin, Kirsten
AU - Pickering, John
N1 - Funding Information:
The NZEMN members at the time of this study were: Peter Jones, Martin Than, Stuart Dalziel, Gregory Luke Larkin, Kim Yates, Alastair MacLean, Thomas Cheri, Andrew Munro, Andy Brainard, TeRina Joseph, Marama Tauranga, Paul Quigley, Brad Peckler, Richard Makower, Martyn Harvey, Martin Watts, Dominic Fleischer, Craig Ellis, Collen Macgregor, Jonathan Henry, Karen Schimanski, Marc Gutenstein, Margaret Colligan, Frann Sawtell, Nancy Mitchell, Joanna Wailing, Mark Hussey, Adam Mcleay, Chris Cresswell, Deborah Moore, Derek Sage, Michael Ardagh, James Le Fevre and Donald McKee. The SSED NRP members involved with this study were: Peter Jones, Alana Harper, Susan Wells, James Le Fevre, Joanna Stewart, Elana Curtis, Papaarangi Reid and Shanthi Ameratunga. We thank the data collectors for their assistance with the study: Alastair Maclean, Alice Lagas, Andrew Munro, Anna Nienaber, Berinder Shahpuri, Bruce Lambie, Conrad McCaffrey, Debra Fish, Faten Ragaban, Ian Martin, Kirsten Taplin, Joanna Wailing, John Pickering, Julie Lucas, Katie Pass, Ruth Reid, Kelly Austin, Martin Watts, Max Hattaway, Mazen Shasha, Oliver Welfare, Rachel Mills, Rafy Shasha, Reanne Subritzky, Rebecca Farrar, Wei Tan, Richard Makower, Stuart Dalziel, Sumeshni Jairam and Tamsin Davies. The SSED Study was funded by the Health Research Council of New Zealand 10-588 and SD was funded by the Health Research Council of New Zealand 13-556. The NZEMN is funded for administrative support by the ACEM Foundation. PJ conceived the study and coordinated data collection across the sites. Data were collected by the NZEMN. The data collection tools and the data dictionary used for the study were originally created for the SSED NRP by the members of the SSED NRP Group. PJ undertook statistical analysis and drafted the manuscript. The members of both the NZEMN and SSED NRP critically reviewed and amended the draft manuscript. PJ, SD and MA are section editors for Emergency Medicine Australasia.
Publisher Copyright:
© 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Objective: Pain is a common feature of ED presentations and the timely provision of adequate analgesia is important for patient care. However, there is currently no New Zealand data with respect to this indicator of care quality. The present study aimed to provide a baseline for the quality of care with respect to the provision of timely and adequate analgesia in New Zealand EDs. Methods: The present study is a secondary analysis of data initially collected for the Shorter Stays in Emergency Department Study, using a retrospective chart review of 1685 randomly selected ED presentations (2006–2012) from 26 New Zealand public hospital EDs. Results: Of the 1685 charts randomly selected, 1547 (91%) were reviewed from 21 EDs. There were 866 ED presentations with painful conditions, of whom 132 (15%) did not have pain recorded, 205 (24%) did not receive pain relief and 19 (2%) did not have time of analgesia documented leaving 510 (59%) for the analysis of time to analgesia. Four hundred and fifty-seven (53%) did not have pain well documented sufficiently to assess adequacy, leaving 277 (32%) for the analysis of adequacy of analgesia. The median (interquartile range) time to analgesia was 62 (30–134) min and the provision of adequate analgesia was 141/277 (51%, 95% CI: 45–57%); however, there was some variation between hospitals for both outcomes. Conclusion: Although these outcomes are on a par with other countries, this baseline audit has shown both poor documentation and variation in the provision of timely and adequate pain relief in New Zealand EDs, with room for improvement with respect to this quality indicator.
AB - Objective: Pain is a common feature of ED presentations and the timely provision of adequate analgesia is important for patient care. However, there is currently no New Zealand data with respect to this indicator of care quality. The present study aimed to provide a baseline for the quality of care with respect to the provision of timely and adequate analgesia in New Zealand EDs. Methods: The present study is a secondary analysis of data initially collected for the Shorter Stays in Emergency Department Study, using a retrospective chart review of 1685 randomly selected ED presentations (2006–2012) from 26 New Zealand public hospital EDs. Results: Of the 1685 charts randomly selected, 1547 (91%) were reviewed from 21 EDs. There were 866 ED presentations with painful conditions, of whom 132 (15%) did not have pain recorded, 205 (24%) did not receive pain relief and 19 (2%) did not have time of analgesia documented leaving 510 (59%) for the analysis of time to analgesia. Four hundred and fifty-seven (53%) did not have pain well documented sufficiently to assess adequacy, leaving 277 (32%) for the analysis of adequacy of analgesia. The median (interquartile range) time to analgesia was 62 (30–134) min and the provision of adequate analgesia was 141/277 (51%, 95% CI: 45–57%); however, there was some variation between hospitals for both outcomes. Conclusion: Although these outcomes are on a par with other countries, this baseline audit has shown both poor documentation and variation in the provision of timely and adequate pain relief in New Zealand EDs, with room for improvement with respect to this quality indicator.
KW - analgesia
KW - emergency department
KW - pain
KW - quality
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U2 - 10.1111/1742-6723.12714
DO - 10.1111/1742-6723.12714
M3 - Article
C2 - 28087889
AN - SCOPUS:85010628609
SN - 1742-6731
VL - 29
SP - 165
EP - 172
JO - EMA - Emergency Medicine Australasia
JF - EMA - Emergency Medicine Australasia
IS - 2
ER -