This study aims to increase the use of transcutaneous electrical nerve stimulation (TENS) for acute postoperative pain relief. TENS, a non-pharmacological treatment using electrical impulses, can enhance pain relief, reduce opioid use, and minimize side effects. Despite its benefits, TENS is underused in healthcare. This project will provide TENS education, support from experienced "superusers," and nudging techniques to encourage staff to adopt TENS, ultimately improving pain management and recovery for postoperative patients.
All staff working in the department where the study will be conducted.
Patients scheduled for urological procedures under anesthesia who are 18 years of age or older.
Does not give consent.
Ongoing pregnancy.
Unable to speak or understand Swedish.
Presence of electronic implants (e.g., pacemaker, implantable - defibrillator/ICD).
The study population includes healthcare staff working in the department where the study is conducted and patients who are scheduled for urological procedures under anesthesia and are 18 years or older. The focus is on observing and enhancing TENS usage in postoperative pain management within this specific clinical setting.
Cohort
Prospective
Educational Intervention on TENS Usage
BehavioralEducational sessions on TENS usage and support from designated "superusers" to increase knowledge and skills related to TENS for postoperative pain management.
Nudging Intervention to Promote TENS Usage
BehavioralHealthcare staff exposed to nudging strategies designed to enhance the use of TENS, which involves visual prompts, reminders, and environmental cues aimed at making TENS more salient and encouraging its use for postoperative pain management.
Frequency of TENS Usage in Postoperative Care
Measure the frequency and consistency of TENS usage by healthcare staff for postoperative pain management across the three groups (Control, Education, and Nudging). This outcome will determine the effectiveness of educational and nudging interventions in changing TENS adoption patterns. Scores represent the number of documented TENS applications per patient.
Change in Postoperative Pain Intensity
Assess patient-reported pain intensity using the Visual Analog Scale (VAS) or Numerical Rating Scale (NRS) to evaluate the impact of TENS on pain relief compared to standard care. Scores range from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores reflect worse pain intensity. This measure focuses on immediate postoperative pain change.
Change in Opioid Consumption for Postoperative Pain
Measure the amount of opioid medication administered for postoperative pain relief among patients in each group. This outcome evaluates whether the increase in TENS use changes the need for opioid pain management, contributing to safer postoperative care. Scores are measured in milligrams, where higher values reflect a worse outcome.
Change in Postoperative Discharge Time
Track the time from surgery to patient discharge in each group (Control, Education, and Nudging) to assess whether increased TENS use facilitates faster recovery. Shorter discharge times indicate improved postoperative recovery, likely linked to better pain management and decreased reliance on opioids. Scores are measured in minutes, where higher values reflect a worse outcome.
Healthcare Staff Perceptions of Educational and Nudging Interventions
Conduct in-depth interviews with 20-25 anesthesia staff members to explore their experiences of the educational and nudging interventions aimed at increasing TENS usage. This outcome will provide insights into facilitators and barriers to TENS adoption, as well as the acceptability and perceived impact of behavioral interventions in a clinical setting.
Patient Experiences of TENS for Postoperative Pain Management
Conduct interviews with 20-25 patients who underwent urological surgery and received TENS as part of their postoperative care. The interviews will explore patients' perspectives on pain relief, ease of TENS use, and the perceived impact on postoperative symptoms such as urinary urgency and bladder spasms. This outcome will help assess patient satisfaction and the subjective effectiveness of TENS in enhancing recovery.
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Pether Jildenstal
Lead sponsor
Göteborg University
Sponsor institution
Sahlgrenska University Hospital
Collaborator
