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dc.contributor.authorBotti, M
dc.contributor.authorKent, B
dc.contributor.authorBucknall, T
dc.contributor.authorDuke, M
dc.contributor.authorJohnstone, M-J
dc.contributor.authorConsidine, J
dc.contributor.authorRedley, B
dc.contributor.authorHunter, S
dc.contributor.authorde Steiger, R
dc.contributor.authorHolcombe, M
dc.contributor.authorCohen, E
dc.date.accessioned2016-05-31T13:51:42Z
dc.date.available2016-05-31T13:51:42Z
dc.date.issued2014-12
dc.identifier.issn1748-5908
dc.identifier.issn1748-5908
dc.identifier.other110
dc.identifier.urihttp://hdl.handle.net/10026.1/4774
dc.description.abstract

BACKGROUND: Evidence from clinical practice and the extant literature suggests that post-operative pain assessment and treatment is often suboptimal. Poor pain management is likely to persist until pain management practices become consistent with guidelines developed from the best available scientific evidence. This work will address the priority in healthcare of improving the quality of pain management by standardising evidence-based care processes through the incorporation of an algorithm derived from best evidence into clinical practice. In this paper, the methodology for the creation and implementation of such an algorithm that will focus, in the first instance, on patients who have undergone total hip or knee replacement is described. METHODS: In partnership with clinicians, and based on best available evidence, the aim of the Management Algorithm for Post-operative Pain (MAPP) project is to develop, implement, and evaluate an algorithm designed to support pain management decision-making for patients after orthopaedic surgery. The algorithm will provide guidance for the prescription and administration of multimodal analgesics in the post-operative period, and the treatment of breakthrough pain. The MAPP project is a multisite study with one coordinating hospital and two supporting (rollout) hospitals. The design of this project is a pre-implementation-post-implementation evaluation and will be conducted over three phases. The Promoting Action on Research Implementation in Health Services (PARiHS) framework will be used to guide implementation. Outcome measurements will be taken 10 weeks post-implementation of the MAPP. The primary outcomes are: proportion of patients prescribed multimodal analgesics in accordance with the MAPP; and proportion of patients with moderate to severe pain intensity at rest. These data will be compared to the pre-implementation analgesic prescribing practices and pain outcome measures. A secondary outcome, the efficacy of the MAPP, will be measured by comparing pain intensity scores of patients where the MAPP guidelines were or were not followed. DISCUSSION: The outcomes of this study have relevance for nursing and medical professionals as well as informing health service evaluation. In establishing a framework for the sustainable implementation and evaluation of a standardised approach to post-operative pain management, the findings have implications for clinicians and patients within multiple surgical contexts.

dc.format.extent110-
dc.format.mediumElectronic
dc.languageen
dc.language.isoeng
dc.publisherSpringer Science and Business Media LLC
dc.subjectPain
dc.subjectPain management
dc.subjectPost-operative pain
dc.subjectAlgorithm
dc.subjectOrthopaedic
dc.subjectEvidence-based practice
dc.subjectClinical decision making
dc.subjectImplementation
dc.titleDevelopment of a Management Algorithm for Post-operative Pain (MAPP) after total knee and total hip replacement: study rationale and design
dc.typejournal-article
dc.typeJournal Article
dc.typeResearch Support, Non-U.S. Gov't
plymouth.author-urlhttps://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000342021700001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008
plymouth.issue1
plymouth.volume9
plymouth.publication-statusPublished
plymouth.journalImplementation Science
dc.identifier.doi10.1186/s13012-014-0110-3
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/School of Nursing and Midwifery
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeEngland
dcterms.dateAccepted2014-08-11
dc.identifier.eissn1748-5908
dc.rights.embargoperiodNo embargo
rioxxterms.versionofrecord10.1186/s13012-014-0110-3
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2014-08-28
rioxxterms.typeJournal Article/Review


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