Preoperative Pain Management Education and Narcotic Use: A Quality Improvement Project

Sarah Scheller, Sacred Heart University

A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.


Introduction: Comprehensive preoperative education is an important aspect of pain management and helps empower patients prior to their surgery. Evidence supports the use of a combination of the teach-back method, videos, and pamphlets to educate patients prior to their surgery. A quality improvement project was initiated for patients having total shoulder arthroplasty surgery with an orthopedic surgeon in Connecticut.

Methods: An educational video and handout were created, and preoperative education sessions using the teach-back methods were performed. Postoperative phone calls were placed at 24 and 72 hours to assess the patient’s use of narcotic pain medication, alternative pain management medication and techniques, and their satisfaction with their pain management education. Three Plan-Do-Study-Act (PDSA) cycles were used to modify and improve the education during the project’s implementation.

Results: 16 patients were educated, and postoperative phone calls were completed on 14 patients. All patients reported that they were satisfied or very satisfied with their pain management and knowledge about pain management, with pain levels ranging from zero to three on a one to ten scale. Patients reported their pain was well managed with the number of narcotic pain medication doses they were taking and reported feeling well prepared for their surgery.

Conclusion: Overall the patients, the orthopedic surgeon and their staff all were very satisfied with the new educational materials, and they will continue to use the new methods for future patient education.