Pain management practices during wound care in patients with moderate to major burn injuries, kenyatta national hospital, Kenya

Background: Burn wound care procedures lead to trauma and excruciating pain and this is associated with longer bed occupancy and poor outcomes. Burn cause a lot of pain in most circumstances and has not been sufficiently controlled leading to psychological consequences and poor wound healing. The study therefore sought to determine pain management practices during wound care procedures in patients with moderate to major burn injuries in Burns Unit and ward in Kenya’s biggest referral hospital, in view of finding out current practices in pain management in severe burn patients for better patient care. Methodology: The study employed a qualitative cross sectional design in which eighty (80) patients selected through purposive sampling method and who met inclusion criteria were recruited into the study. Data was collected using structured questionnaire consisting of two parts: Patient data (demographic and pain scales) and clinician pain management practices. The analysis was done using Statistical Package for Social Scientists (SPSS) version 18 and presented using charts and tables. Results: Patients reported significant increase of pain during wound care procedures with mean pain score 8.5 SD 1.4, P=0.001 in both numerical and behavioral pain scales. Patients who were only on paracetamol analgesic reported more pain during wound care procedures (mean change 5.66) compared to morphine (mean change 4.37, P=0.033). Patients who received non pharmacological pain management practices in addition to pharmacological pain management reported less pain than those who did not benefit from them, P=0.004. Conclusion: Clinicians pain management practices during wound care procedures involved pharmacological as well as non pharmacological pain management; however their pain dissipation was inadequate. Innovative pain management practices combining both pharmacological and non pharmacological therapies need to be implemented and / or researched on.