Patient-controlled analgesia: Patient and nurse satisfaction with intravenous delivery systems and expected satisfaction with transdermal delivery systems

Objective: To compare patient and nurse satisfaction with intravenous patient-controlled analgesia (IV-PCA) to their prospective satisfaction with patient-controlled transdermal delivery system (PCTS) technology. Methods: Nationwide samples of 301 nurses (200 medical-surgical, 101 post-anesthesia care units) and 500 surgery patients (192 abdominal, 119 gynecological, 189 orthopedic) completed self-administered, Internet-based questionnaires. Respondents indicated satisfaction with attributes of IV-PCA and, after reading a description of PCTS, indicated prospective satisfaction with comparable attributes. Within patient and nurse samples, half rated IV-PCA first (and later re-rated overall satisfaction) and half rated PCTS first. Paired comparison t-tests were used to determine significant differences in satisfaction for IV-PCA and PCTS attributes. Results: Nurses reported significantly higher satisfaction with PCTS for patient and nurse ease of use, safety, and tolerability (p < 0.001 for all); and higher satisfaction with IV-PCA for the ability to vary drugs (p < 0.001) and doses (p < 0.001), deliver basal doses (p < 0.001), and dose tracking accessibility (p = 0.003) and quality (p = 0.002). Patients reported significantly higher satisfaction with PCTS for pain relief (p < 0.001), safety (p = 0.027), self-control (p < 0.001), and patient (p < 0.001) and nurse ease of use (p < 0.001); and higher satisfaction with IV-PCA for correct set-up and programming (p = 0.002). Overall satisfaction did not differ significantly among nurses, but among patients satisfaction with IV-PCA declined after considering PCTS (p < 0.001). Nurses placed greater importance on safety to their overall satisfaction than patients did. Limitations: Only respondents with Internet access were included. PCTS satisfaction is hypothetical and may not reflect true product satisfaction. Conclusion: PCTS is a novel delivery system for postoperative pain and has the potential to improve patient and nurse satisfaction over IV-PCA.