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

Nursing Implications

Providing safe, effective pain management is a concern to all nurses caring for patients following surgery. Registered nurses at all levels of practice are primary patient advocates who have a vital role in managing postoperative pain appropriately. Patient comorbidities create challenges to managing pain and preventing adverse effects caused by analgesics (Ahmed, 2011). The decision tree model concisely assembles current evidence while considering patient co-morbidities and medication characteristics.

When using the decision tree to find recommendations for multi-modal pain management, the nurse first should identify the type of pain being experienced by the patient and then answer the questions. Each question under the type of pain should be answered because the patient may have more than one co-morbidity. The decision tree is followed until the interventions are reached. Nonopioid and opioid medications as well as nonpharmacologic interventions are suggested. Medications that should be avoided and other suggested cautions are based on the characteristics or co-morbidities of the individual patient.