Music Therapy in the PACU: An Evidence Based Practice Project on Multimodal Postoperative Pain Interventions

BACKGROUND: Postoperative patients come to the PACU where pain and anxiety are priorities in care. Creating healing environments in PACU is often difficult due to open bays and constant movement and patient transports from operating rooms. Medication is often offered to relieve patients’ unrest in the anxiety-provoking environment, which leads to increased medication needs and prolonged admissions. Studies demonstrate how music therapy with current care practices effectively decrease pain, anxiety, and medication requirements in the PACU.

LOCAL PROBLEM: The setting was the main PACU of a Level I trauma hospital in Tennessee. The PACU nurse manager identified increased medication needs due to a poor healing environment and extended recovery times as a problem in the unit. The purpose of this initiative was implementing music therapy as a nonpharmacological pain intervention in hopes of decreasing pain and anxiety scores by 25% within patient recovery.

METHODS: The Evidence-based Practice Improvement (EBPI) model was used to guide this project. PDSA (plan-do-study-act) cycles determined music therapy implementation via computers within patient slots. Phase 1 collected 300 patient data scores determining baseline pain and anxiety, and phase 2 collected the same with addition of music therapy. Satisfaction surveys were completed in patients who had music therapy in phase 2.

INTERVENTIONS: Patients rated pain between 0 and 10 on the Numeric Rating Scale. Anxiety rated similarly with the Visual Analogue Scale for Anxiety. A two-part satisfaction survey was completed in music therapy patients.

RESULTS: The sole interaction between music therapy with pain and anxiety scores was not statistically significant; however, in patients who felt pain and anxiety arriving to PACU, there was a statistically significant relationship between music satisfaction and music’s benefit in reducing pain and anxiety.

CONCLUSIONS: Implementing music therapy in PACU is a zero-cost quality improvement practice change with potentially positive impacts on both patients and staff in recovery units.