A Decision Tree Model for Postoperative Pain Management

Cynthia W. Ward, DNP, RN-BC, CMSRN, ACNS-BC


Urol Nurs. 2015;35(5):251-256. 

In This Article

Decision Tree Model Flowchart for Management of Postoperative Pain

A decision tree model flowchart is used to represent a decision process graphically (see Figure 1). Different symbols are used to signify specific actions taken at that step in the process. An oval shape indicates the beginning or end of the process, a rectangle indicates an action step, and a diamond indicates a decision (Hebb, 2012).

Figure 1.

Decision Tree Model Flowchart for Management of Postoperative Pain

Recommendations for the flowchart presented in Figure 1 were made based on the evidence for the type of pain as well as patient characteristics or comorbidities. Al though pain is expected to decrease with time following surgery, pain is subjective (Pasero & Portenoy, 2011); thus recommendations are made based on the intensity of pain rather than the postoperative day.

Medications are given intravenously immediately after surgery. The transition to oral analgesics should be made as soon as possible when the individual is tolerating oral fluids. Due to possible hepatotoxic effects of acetaminophen, combination medications that include acetaminophen should be avoided; opioid and nonopioid medications should be given separately (Pasero et al., 2011).