在儿科重症监护中的疼痛评估和管理决策
Elyse Laures1, Janet Williams2, Ann Marie McCarthy2
1University of Iowa College of Nursing, 50 Newton Drive, Iowa City, IA 52242, United States of America; University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA 52242, United States of America.
Journal of pediatric nursing
|October 26, 2023
概括
儿科重症监护室 (PICU) 的护士使用生理学线索来评估呼吸,的儿童的疼痛. 决策因个人解释和外部因素而有所不同,这凸显了需要改进疼痛管理工具的需要.
科学领域:
- 儿科重症监护护理护理 儿科重症监护护理
- 在重症儿童的疼痛管理.
- 定性研究方法 定性研究方法
背景情况:
- 有效的疼痛管理对于在儿科重症监护室 (PICU) 的机械通风和化学麻儿童至关重要.
- 评估非通讯性儿科患者的疼痛对临床医生来说是一个独特的挑战.
- 了解护士的决策过程对于优化疼痛管理策略至关重要.
研究的目的:
- 探索PICU护士在机械通风和化学麻儿童的疼痛管理方面的决策过程.
- 确定护士用来评估疼痛的线索以及影响其管理决策的因素.
主要方法:
- 在定量阶段之后,采用了定性描述性设计.
- 与18名PICU护士进行了半结构化采访.
- 内容分析用于编码和主题生成.
主要成果:
- 护士主要依靠生理线索来评估疼痛.
- 出现了三个主题:疼痛评估线索,护士解释线索的心理模型,以及影响决策的外部因素.
- 护士如何解释线索并做出疼痛管理决策存在显著差异,受单位文化,障碍,促进者和经验的影响.
结论:
- 在这个人群中,护士对疼痛管理决策的心理模型显示出相当大的差异.
- 报告称,有关疼痛和镇静剂量表的选择和不一致的文档实践存在困惑.
- "假设疼痛存在"成为一个需要进一步调查的潜在指导概念.
相关概念视频
Peripheral Artery Disease IV: Nursing Management
11
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
11
Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
Angina V: Nursing Management
18
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
18
Pericarditis IV: Nursing Management
18
Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
18
Chronic Obstructive Pulmonary Disease-V: Nursing Management
3.9K
Nursing management of Chronic Obstructive Pulmonary Disease (COPD) is crucial for providing thorough care and support to patients. Nurses play an integral role in this process through detailed assessment, careful planning, targeted interventions, and ongoing evaluation. Here's an overview of the critical steps in nursing management for COPD.
Assessment
Assessment
3.9K
Planning Nursing Care I
4.5K
The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
4.5K


