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Evaluation of an oral patient-controlled analgesia device for pain management in oncology inpatients.

An oral, patient-controlled analgesia (PCA) device uses radiofrequency identification technology to allow patients direct, controlled access to medication at the bedside. Twenty oncology inpatients participated in a pilot study to evaluate the device's design function and patient, nursing, and pharmacy satisfaction. The referring oncology physicians ordered oral pain tablets or capsules on an as-needed basis; the drugs were dispensed by the device with a specified lockout time interval and with a provision for administration of an immediate dose, if desired. In all, 95% of the patients reported that use of the device provided better pain control, since it allowed them to receive medication directly without delay. Further, 100% of the patients preferred using the device to calling a nurse for each dose of as-needed medication. All patients desired to use the device again during future hospitalizations if they required oral breakthrough pain medications. More than 80% of nurses surveyed stated that the device was reliable and easy both to program and to query about medication-dispensing data. In addition, more than 90% of nurses reported that patients' pain appeared to be better controlled when the device was used; they also indicated that the device saved them nursing time. Pharmacy staff agreed that the device's disposable medication tray was easy to fill; however, it did not save them time. The results of a Cronbach's-alpha statistic calculated for patient and nursing questionnaires showed these surveys to be reliable tools that featured consistent responses. The overall conclusion from this pilot study was that the oral PCA device was a useful, functional device that should improve pain management in selected patients in the acute care setting.