A prospective audit project into the adequacy of XXXX assessment in the medical and surgical wards in a North London District General Hospital.

@entity1 @entity158
BACKGROUND: Accurate assessment of @entity158 is associated with improved @entity158 management, which can lead to better @entity1 outcomes. It has been recommended that all @entity1 have their @entity158 assessed and the scores documented as the 'fifth vital sign'. METHOD: All inpatients in the medical and surgical wards in our hospital were asked directly to score their @entity158 according to the hospital-wide scoring system. Their observation charts and drug charts were then reviewed in order to determine the accuracy of documented @entity158 assessments and the subsequent analgesic management. RESULTS: Of the 208 @entity1 reviewed, 20 (15%) @entity1 on medical wards and 26 (38%) @entity1 on surgical wards were in moderate to severe @entity158 . Documentation of @entity158 scores was not universal, with 29 (14%) @entity1 having no score documented with their last set of observations. Of those with a score recorded, it was not found to correlate with the scores reported on direct questioning in 41% of medical @entity1 and 71% of surgical @entity1 . Provision of analgesia was also found to differ between medical and surgical wards. DISCUSSION: The care of @entity158 in the wards falls below the standards set by the Royal College of Anaesthetists. It is necessary to undertake a programme of education to increase awareness of the problem and to improve assessment and management to enhance the @entity1 experience.
