对接受机械通风的化学麻儿童的疼痛评估和管理
Elyse L Laures1, Cynthia M LaFond2, Barbara St Marie3
1Elyse L. Laures is a nurse scientist, University of Iowa Hospitals and Clinics, and instructional track faculty, University of Iowa College of Nursing, Iowa City.
概括
在接受神经肌肉阻塞 (NMB) 的机械通风儿童中评估疼痛是具有挑战性的. 护士经常使用行为尺度,但生理线索显著增加疼痛干预,突出了为儿科重症监护室 (PICU) 疼痛管理提供更好的决策支持工具的需要.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 护理实践 护理实践
- 疼痛管理 疼痛管理
背景情况:
- 儿科重症监护室 (PICU) 的疼痛评估对于需要神经肌肉阻塞 (NMB) 的机械通风儿童来说是复杂的.
- 目前,对于这种特定的儿科患者群体,没有经过验证的疼痛评估方法.
- 这一群人疼痛评估的现有指导方针仅限于生理变量,使基于实践的方法不清楚.
研究的目的:
- 调查和描述PICU护士在评估和管理需要NMB的儿童疼痛时的现有做法.
- 确定护士在NMB下评估重症儿科患者的疼痛时使用的方法和变量.
主要方法:
- 采用了一种横截面的定量研究设计.
- 对107名PICU护士进行电子调查.
- 护士们回应了描绘各种临床情景的片段,其中涉及需要NMB和潜在疼痛刺激的儿童.
主要成果:
- 护士主要使用行为评估尺度 (61.0%) 来评估疼痛.
- 所有护士都认为生理变量很重要,27.3%的护士正式使用"假设疼痛存在"的方法.
- 生理学线索的存在显著增加了疼痛干预的可能性 (OR 23.3,P < .001).
结论:
- 护士如何评估接受NMB的儿科患者的疼痛存在显著差异.
- 目前对行为尺度的依赖是有问题的,因为它们没有对这个人群进行验证.
- 制定决策支持工具对于提高这一脆弱群体的有效疼痛评估和管理至关重要.
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