Abstract
Background: Emergency clinicians perform many routine procedures that may add to the pain burden of patients. Many factors influence the level of patient satisfaction with procedure related pain management in the emergency department (ED). This paper aimed at comparing patient satisfaction with the ED procedure-related pain management based on the training level and gender of the provider.
Methods: This study was based on a prospective cross-sectional survey performed between June and November 2009 at an urban level-1 trauma center. Researchers interviewed a convenience sample of English speaking non-psychiatric adult patients who received ED procedures such as suturing and incision and drainage. Patients completed a confidential, post-procedure survey that collected information on demographics and satisfaction on a scale of 1 to 4 (1 = completely dissatisfied, 4= completely satisfied). Researchers recorded the training level and gender of providers. Data was analyzed with descriptive statistics and comparative analyses were performed with one-way analysis of variance and chi-square tests where appropriate.
Results: Overall, 75 patients participated. The average age was 39 years (60.8% male and 60.8% African-American). Procedures included sutures (57.3%), lumbar punctures (12.0%),central line placement (4.0%), incision and drainage (20.0%) and closed reduction (6.7%).Procedures were performed by advanced practice nurses (14.7%), medical students (14.7%),attending physicians (6.6%) and residents (64.0%). Females comprised 53.3% of the providers.The median pain rating before procedures was 7 out of 10. Mean satisfaction scores with pain management did not differ (P = 0.639) between nurse practitioners (3.64), students (3.60),attending physicians (3.60) and residents (3.33), nor between male and female providers (3.40 vs 3.49; P = 0.688).
Conclusion: Provider training level and gender did not impact patient satisfaction with pain management for ED procedures in this study.