Patient factors and outpatient pain control in patients discharged from a regional burn center with minor-to-medium-sized burns

Title : Patient factors and outpatient pain control in patients discharged from a regional burn center with minor-to-medium-sized burns

Abstract:

Background: The idea for this study began in our outpatient burn clinic, where practitioners noticed the burn clinic was receiving numerous phone calls regarding uncontrolled pain after discharge. This prompted the question, why? Why are patients having uncontrolled pain and why is the medication not helping them?

Objectives: Goals for this study is to explore the efficacy of pain control in patients with thermal burns post discharge from the hospital and to identify non-injury patient factors associated with reported pain.

Design: Retrospective Cohort Study

Methods: Institutional Review Board (IRB) approval was granted to perform this project using a HIPAA waiver. A systematic review of all adult patients seen in the burn clinic between October 1^st, 2016 – April 30^th, 2017 was performed. Inclusion criteria included adult patients with thermal injuries involving less than 15% of total body surface area (TBSA) presenting to the clinic for initial follow up after treatment at the burn center. Data regarding patient demographics, social history and mental health diagnoses were collected from patient’s electronic medical record (EPIC) and analyzed for results. Averages were determined as arithmetic mean +/- standard deviation. Differences in reported pain scores between groups were assessed for significance using unpaired two-tailed-test.

Results: A total of 409 patients were admitted to the Burn Center during the study period, with n=104 patients meeting criteria for this study. On univariate analysis, the presence of mental health disorder prior to burn injury was found to have a higher statistically significant association with higher reported pain scores on initial follow-up clinic visit ( p=0.02).

Conclusions: Patients with a history of mental health disorder report significantly more pain, than those without such diagnosis. Further exploration of this finding is to identify ways in which uncontrolled pain after discharge can be prevented.

Audience Take Away:

• To explore the efficacy of pain control in patients with thermal burns admitted to an American Burn Association (ABA) verified burn center post discharge.
• Document the subjective pain control for burn patients discharged from an American Burn Association (ABA) verified burn center.
• To identify non-injury patient factors associated with reported pain.

Biography:

Amelia Nichols Alava graduated with her Baccalaureate of Science in nursing degree in 2016. She has worked in the medical field for over 10 years, with experience in the hospital and clinic settings. Amelia is a Registered Nurse in the UF Health Burn Center, in the intensive care unit and outpatient clinic. She has recently been promoted to Clinical Leader for a Medical Surgical Unit at UF Health. She is involved in many Nursing Councils at UF Health, along with her involvement in research studies.

Currently enrolled in the Doctorate in Nursing Practice program at the University of Florida, with a specialty in Acute Care/Gerontology, she aspires to continue with the Burn Center.