Pain Score Levels Acceptable to Patients and Hospital Staff in Trauma & Orthopaedics in A Large District General Hospital

Abstract

Adequate Pain control in trauma and orthopaedic wards is seen as a fundamental equivalence of the quality of medical care worldwide. Despite this, there  is no official standard or numerical value of pain that is acceptable for patients. This study examines
the level of pain accepted by both inpatients and staff in trauma and orthopaedics in a large district hospital. One hundred three adult inpatients, 46 males and 57 females, were recruited in a prospective blinded cross-sectional study. Pain numerical rating scale (PNRS) and satisfaction questionnaires were recorded in a snapshot visit to the orthopaedic and trauma wards. Patients were asked what exact level of pain would be acceptable for them from zero to 10. Similarly, 51 staff colleagues were asked the same question as to what pain level is thought to be acceptable for them if they were in pain before asking for analgesia. The average acceptable PNRS for patients was 4.7/10 (SD±1.7), whereas the average PNRS which staff deemed acceptable was 4.2/10 (SD±1.3). In the snapshot survey, seventy (68%) of the patients were very satisfied with the pain management as a whole, 30 (29%) satisfied, and 3 (3%) thought that the pain control was poor. The Pain VRS (Verbal  Rating Scale) and the pain control satisfaction correlated well. (p<0.0001) In conclusion, the acceptable average pain level was found to be 4.45 out of 10  for patients and staff combined. When compared to doctors; nurses underestimated pain perceived by in patients by over one point out of three on average in pain verbal rating scale.