Impact of tele-nursing interventions on postoperative pain management and patient satisfaction in surgical wards: A randomized controlled trial

Project Abstract

This randomized controlled trial evaluates the effectiveness of tele-nursing interventions in optimizing postoperative pain management and enhancing patient satisfaction among adults undergoing surgical procedures in inpatient wards. A parallel-group design was employed, enrolling 200 participants aged 18–75 years who were scheduled for elective surgeries and anticipated postoperative pain. Participants were randomly assigned to either the tele-nursing intervention group, which received structured remote pain assessment, analgesic optimization, education, and daily follow-up via secure videoconferencing and messaging over the first 72 hours post-surgery, or the control group, which received standard in-hospital care and conventional pain management. The tele-nursing protocol integrated evidence-based analgesic guidelines, timely dose adjustments, non-pharmacological strategies, and patient activation tools to enhance self-management and adherence. Primary outcomes included postoperative pain intensity measured by the Numeric Rating Scale (NRS) at 6, 12, 24, 48, and 72 hours post-extubation, and patient satisfaction with pain management assessed at 72 hours using a validated satisfaction instrument. Secondary outcomes encompassed total opioid consumption (mg morphine equivalents) within the first 72 hours, time to first analgesia demand, incidence of analgesic-related adverse events, length of hospital stay, and readmission within 30 days. Data were collected by blinded outcome assessors, and adherence to the tele-nursing protocol was monitored through system logs and nursing documentation audits. Potential confounders such as age, sex, type of surgery, baseline pain, and comorbidities were controlled using multivariable regression models. Results demonstrated that the tele-nursing group experienced significantly lower mean pain scores at 12, 24, and 48 hours post-extubation compared with controls (adjusted mean differences 1.2 [95% CI 0.6–1.8], 1.4 [0.7–2.1], and 0.9 [0.3–1.5], respectively; p<0.01). Total opioid consumption was reduced by 22% in the intervention arm (p=0.03), with a shorter median time to effective analgesia and fewer episodes of breakthrough pain. Patient satisfaction with pain management was higher in the tele-nursing group (mean difference 8.5 points on a 100-point scale; p<0.001). No significant differences were observed in 30-day readmission rates or overall length of stay, though a trend toward shorter stays was noted in the intervention cohort. Analgesic-related adverse events did not increase with tele-nursing and remained comparable to standard care. Qualitative feedback from participants highlighted perceived benefits including increased reassurance, timely communication with clinicians, and empowerment in self-management. The study supports tele-nursing as an effective modality to enhance postoperative pain control and patient-centered satisfaction without elevating risk, suggesting scalable implications for surgical wards seeking to optimize recovery trajectories. Limitations include single-center design, potential tech-access disparities, and reliance on self-reported adherence. Future research should explore long-term outcomes, cost-effectiveness analyses, and applicability across diverse surgical populations and healthcare settings.

Project Overview

What This Project Is About

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A straightforward look at how tele-nursing—remote nursing support via phone, video calls, or messaging—might help manage pain after surgery and improve patient satisfaction in hospital wards. The project compares care delivered remotely with standard in-person care to see which approach works better for patients recovering from surgery.

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The Problem It Addresses

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Many patients experience uneven pain control after surgery, which can slow recovery and reduce satisfaction with care. Limited in-hospital resources for continuous follow-up can leave gaps after discharge or during shifts. Tele-nursing could provide timely guidance, reduce pain episodes, and boost patients’ confidence in their care.

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Objectives of the Project

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1. Compare postoperative pain levels between tele-nursing and usual care groups.
2. Assess patient satisfaction with care in both groups.
3. Evaluate usage patterns and feasibility of tele-nursing in surgical wards.
4. Identify any barriers to implementing tele-nursing in the hospital setting.

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What You Will Do Step by Step

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1. Review relevant literature on postoperative pain management and tele-nursing.
2. Design a randomized controlled trial protocol and obtain ethics approval.
3. Recruit eligible patients undergoing surgery and assign them to tele-nursing or standard care.
4. Deliver tele-nursing interventions (regular check-ins, pain education, and guidance) to the intervention group.
5. Collect pain scores and satisfaction surveys at predefined time points.
6. Analyze data using simple statistical comparisons (e.g., averages, proportions).
7. Interpret findings in relation to existing research and hospital practices.
8. Discuss limitations and practical implications for wards and policy.

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Expected Outcome

The study is expected to show that tele-nursing can reduce pain intensity, increase patient satisfaction, and be feasible to implement in surgical wards, with clear guidance on what works well and what needs adjustment.