{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T08:37:03Z","timestamp":1792917423335,"version":"4.5.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early postoperative pain can impede mobilisation after orthopaedic surgery. We evaluated whether a nurse-led closed-loop pain-management workflow was associated with improved care processes and early pain outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-centre retrospective pre-\/post-implementation cohort study included adult orthopaedic inpatients returning to standard ward care. The workflow specified numerical rating scale (NRS, 0\u201310) documentation, escalation for NRS \u22654, and reassessment within 30\u201360 minutes after rescue analgesia. The primary outcome was ineffective pain control within 0\u201324 h, defined as any NRS \u22654. Secondary outcomes included 0\u201348 h pain control, peak rest and movement-evoked pain, adverse events, rescue\/opioid exposure, and inpatient satisfaction. Multivariable logistic regression and sensitivity analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 206 patients (pre-implementation n=98; post-implementation n=108), pain assessments increased from a median of 4.0 to 6.0 (P&lt;0.001), and movement-evoked pain documentation increased from 34.7% to 72.2% (P&lt;0.001). In the time-stamped subset, median time to first rescue analgesia decreased from 55 to 30 minutes (P&lt;0.001), while closed-loop completion increased from 37.8% to 80.0% (P=0.002). Ineffective 0\u201324 h pain control decreased from 38.8% to 24.1% (P=0.023), and peak movement-evoked pain decreased from 6.0 to 5.0 (P&lt;0.001). High satisfaction increased from 67.3% to 80.6% (P=0.030). Post-implementation status remained associated with lower odds of ineffective pain control (adjusted OR 0.53, 95% CI 0.29\u20130.96) and higher odds of high satisfaction (adjusted OR 1.92, 95% CI 1.03\u20133.60).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A nurse-led closed-loop pain-management workflow was associated with more timely pain-care processes and improved early postoperative pain outcomes in orthopaedic inpatients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10225536261494676","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T20:15:09Z","timestamp":1792613709000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of a nurse-led closed-loop pain management workflow with early postoperative pain outcomes in orthopaedic inpatients: A single-centre retrospective pre-\/post-implementation study"],"prefix":"10.1177","volume":"34","author":[{"given":"Jie","family":"Yan","sequence":"first","affiliation":[{"name":"Affiliated Hospital of Bei Hua University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Yang","sequence":"additional","affiliation":[{"name":"Huai\u2019an Hospital of Huai\u2019an City"},{"name":"(Huai\u2019an Clinical Medical College of Jiangsu University)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junyan","family":"Liu","sequence":"additional","affiliation":[{"name":"Cangzhou Hospital of Integrated TCM-WM\u00b7HEBEI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5813-9027","authenticated-orcid":false,"given":"Danhua","family":"Lou","sequence":"additional","affiliation":[{"name":"Hangzhou Red Cross Hospital Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.16391"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31828866b3"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.02.008"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/1749-799X-1-3"},{"issue":"7","key":"e_1_3_6_6_2","first-page":"e65872","article-title":"Quality of Postoperative Pain Management in Orthopedic Patients and Its Impact on Sleep Quality and Patient Satisfaction: An Integrative Review","volume":"16","author":"Alqaisi OM","year":"2024","unstructured":"Alqaisi OM, Al-Ghabeesh S. Quality of Postoperative Pain Management in Orthopedic Patients and Its Impact on Sleep Quality and Patient Satisfaction: An Integrative Review. Cureus 2024; 16(7): e65872. https:\/\/doi.org\/10.7759\/cureus.65872","journal-title":"Cureus"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002583"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.10.023"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0898"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2023.05.002"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13741-017-0064-5"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0b013e3181b20745"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2019.07.016"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.13714"},{"issue":"6","key":"e_1_3_6_15_2","first-page":"869","article-title":"[The nurse's role in the postoperative pain management]","volume":"58","author":"Ubino V","year":"2003","unstructured":"Ubino V. [The nurse's role in the postoperative pain management]. Minerva Chir 2003; 58(6): 869\u2013873, Ruolo dell'infermiere nel trattamento del dolore postoperatorio.","journal-title":"Minerva Chir"},{"key":"e_1_3_6_16_2","doi-asserted-by":"crossref","first-page":"e20240110","DOI":"10.1590\/1980-220x-reeusp-2024-0110en","article-title":"Quality of nursing care in pain management in orthopedic surgical patients: a scoping review","volume":"58","author":"Fontes BV","year":"2024","unstructured":"Fontes BV, Oliveira AM, Moraes \u00c9B, et al. Quality of nursing care in pain management in orthopedic surgical patients: a scoping review. Rev Esc Enferm USP 2024; 58: e20240110. https:\/\/doi.org\/10.1590\/1980-220X-REEUSP-2024-0110en","journal-title":"Rev Esc Enferm USP"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2023.108123"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2022-103929"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-003567"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000006574"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004850"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.12.008"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.NAJ.0000944916.30662.5c"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.4103\/ija.ija_1067_25"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.122.009277"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS-24-02426"}],"container-title":["Journal of Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10225536261494676","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10225536261494676","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10225536261494676","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T08:13:33Z","timestamp":1792916013000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10225536261494676"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/10225536261494676"],"URL":"https:\/\/doi.org\/10.1177\/10225536261494676","relation":{},"ISSN":["1022-5536","2309-4990"],"issn-type":[{"value":"1022-5536","type":"print"},{"value":"2309-4990","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"article-number":"10225536261494676"}}