Quality of nursing care in pain management in orthopedic surgical patients: a scoping review.
Bárbara Ventura Fontes, Amanda Magalhaes de Oliveira, Érica Brandão de Moraes and 3 others
PMID 39652719WHAT IT FOUND
Nursing pain care for orthopedic surgical patients included protocols, staff training, pain scales, patient education, participation, specialized teams, and non-drug options.
The review did not test whether these improve pain.
Key findings
01The review included 94 studies of adult orthopedic surgical patients in hospital settings.
02Non-pharmacological pain relief was the most frequently identified practice, evidenced in 34.4% of cases; other practices included effective management (14.6%), education for pain self-management (13.5%), innovative procedures (10.4%), specialized pain teams (10.4%), active patient participation (7.3%), pain assessment scales (5.2%), and individualized attention (4.2%).
03Practices were grouped into unit organization and patient monitoring, preoperative care, and postoperative care, including staff training, protocols, care planning, patient education, participation, pain scales, multimodal drug therapy, patient-controlled analgesia, and non-drug methods.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review did not assess the quality or risk of bias of the included studies, so it cannot say whether these practices improve pain, satisfaction, or recovery. It included literature reviews, expert opinion, protocols, and studies of different designs, so the evidence is not all patient-level trial evidence. The included studies varied in surgery type, country, setting, and outcome, and the review did not combine results to identify the best practice. The review reports how often practices appeared in the included evidence, not how effective they are.
Declared interests
Funded in part by CAPES/COFEN Programa de Desenvolvimento de Pós-Graduação, professional master's modality, registration number COFEN-20211946906P. No author conflicts of interest are stated.
The easy way to misread this
Do not read the list of practices, or the 34.4% figure for non-pharmacological approaches, as proof that they reduce pain. The review mapped included studies and did not assess quality or risk of bias, and it does not provide recommendations on effectiveness.