Special post-op toolkit leads to pain-free experience for children
Parents have praised a new initiative which helps to keep their child pain free and at home following specialist surgery at our Children’s Hospital.
The Anaesthetic and Surgical Maxillofacial Team have designed a cutting-edge method which discharges youngsters with a device that releases a fixed amount of local anaesthetic (numbing medicine) into their system to relieve pain.
Parents have been specially trained by clinicians to care for the youngster at home after they have undergone a procedure known as alveolar bone graft surgery. The operation involves taking a piece of bone from the hip to fill a gap in their palate if they were born with a cleft palate.
A plastic pump is connected to a tube, known as a wound catheter and placed under the patient’s skin.
It means the young patients undergo the operation and are home within a day – with no need to stay overnight.
Dr Federica Merella and Dr Saba Iqbal, both Consultant Paediatric Anaesthetists (pictured), who introduced the toolkit, said: “The patient experience was the main focus of this initiative and the feedback we have received so far has been extremely positive.
“The procedure is known to be painful and traditionally we would keep the child in the ward to administer the numbing medicine overnight and remove the tube after 24 hours.
“This would mean a longer hospital stay. The other alternative was to give the patient oral painkillers only. However, our Acute Pain Team observed that this new method a better way to assure pain relief with the child able to walk pain free.”
Following the examples of several hospitals in the United States that had implemented a similar service in surgical patients, Dr Merella said they worked closely with Rachel Desai, Acute Pain Service Nurse Consultant, to develop educational material for parents.
As part of the quality improvement initiative, Federica and Saba designed a video and leaflet explaining how to look after the wound catheter and pump on the child and provide visual instructions needed to remove the device when it is no longer required.
“We know that patients have better experience when they are cared for at home because they are in a familiar environment and have those comforts around them,” Federica explained.
“By cutting out a hospital stay we managed to reduce waiting times, any issues around cancellations due to bed shortages, while delivering the best quality of pain relief.
“Parents feel empowered and more than 90 per cent surveyed about the treatment plan have said it was excellent or good. More than 85 per cent said they would recommend this model of care to other parents.”
To maintain the safest standard, parents are not allowed to go home with the pump unless they have read the leaflet and watched and understood the video. They also receive further support from specialist nurses and can call the hospital in case of any questions or issues.
Federica added: “We are now working with the Plastic and Reconstructive team, led by Miss Andrea Jester, to expand this service to some of their patients with the hope to replicate the previous success.”