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There is an increasing drive to make nursing care evidence-based. High quality evidence from systematic reviews relevant to postoperative pain relief exists, yet pain after surgery remains poorly controlled for many patients. This study aimed to assess whether implementing evidence-based pain management improved postoperative pain outcomes. Pain on a 0-10 scale was the primary outcome and analgesic consumption a secondary outcome. A baseline audit was undertaken on four surgical wards to establish whether there was a need for the study. A randomized-controlled trial was then designed to assess the effects of implementing an evidence-based approach to postoperative pain management. The four wards were randomized to receive the intervention or act as a control. Outcomes were assessed 3 months after the intervention on both intervention and control wards. The intervention (implementation of an oral analgesic algorithm derived from systematic reviews) was then implemented on the control wards and outcomes reassessed after 3 months on the control wards. The intervention was designed using an evidence-based approach to effective implementation. Four interactive sessions covered: (1) detailed feedback of baseline data and discussion (utilizing audit and feedback), (2) why systematic reviews, analgesic league tables and choice of drugs to develop an analgesic algorithm (see Figure 1), (3) principles of evidence based health care (EBHC), including critical appraisal and (4) facilitation and change workshop. The findings revealed no significant differences in pain level or drug use between the intervention and control wards. However, the control wards also changed during the control period. Possible explanations for this are discussed. When looking at changes compared with baseline, both intervention and control wards increased their use of algorithm drugs and reduced use of non-algorithm drugs during the study. No effects were found on pain in the intervention wards. Pain ratings at rest since surgery, on movement since surgery and worst pain on movement were significantly reduced compared with baseline in the control wards. Although there are many pressures to utilize a randomized-controlled trial study design in the culture of evidence-based health care, there will be times, especially when implementing complex changes in practice that other types of design should be considered.

Thirteen student nurses from the Mental Health and Learning Disability branches (Project 2000) of the School of Care Sciences at the University of Glamorgan volunteered to participate in a research study as research assistants. Participation of this kind represents a novel, practical way of learning about research. Following training and data collection within the research study we evaluated the student's experience of training and participation. Within the survey both quantitative and qualitative data were collected using a self-report questionnaire. Thirteen questionnaires were distributed and twelve completed questionnaires were returned to the School of Care Sciences. The overall results were extremely encouraging with regards to using this approach to increase research awareness. An evaluation of the student's experiences as a researcher confirmed that this was a successful strategy to learning, in particular increasing knowledge of the research process, ethical considerations and skills in interviewing. Involvement also increases the student's awareness of the topic area being studied. Limitations to the study were that this was a small sample.