标准化订单集并不能消除产后疼痛管理中的种族或种族不平等
Celeste A Green1, Jasmine D Johnson2, Christine McKenzie3
1Department of Obstetrics and Gynecology, University of Chapel Hill, Chapel Hill, North Carolina, USA.
Health equity
|November 1, 2023
概括
一个标准化的疼痛管理指令减少了产后阿片类药物使用,但并没有消除剖腹产患者疼痛评估和管理方面的种族和民族差异. 需要进一步的研究来解决这些不平等问题.
科学领域:
- 产科和妇科 产科和妇科
- 医疗保健服务研究 医疗服务研究
- 疼痛管理 疼痛管理
背景情况:
- 在剖腹产后的疼痛管理中,种族和民族的不平等仍然存在.
- 标准化订单集是缓解这些差异的潜在策略.
研究的目的:
- 评估标准化疼痛管理命令对剖腹产后疼痛护理中的种族和民族不平等的影响.
- 量化疼痛评估和管理过程和结果的变化,按种族和种族分层.
主要方法:
- 追溯队列研究,比较标准化剖腹产后订单集的实施前和后的时间.
- 分析电子医疗记录的疼痛评分,疼痛评估和止痛剂量 (阿片类药物,NSAID,乙氨基).
- 倾向性得分调整和差异差异分析,以根据种族/种族来评估疼痛管理结果的变化.
主要成果:
- 在实施后,非西班牙裔黑人患者中,严重的疼痛仍然更为普遍.
- 虽然阿片类药物的使用总体下降,非阿片类止痛药的使用增加,但在评估和治疗方面,种族和民族不平等在很大程度上仍然存在.
- 在西班牙裔患者中,在产后24-48小时内,观察到NSAID剂量的适度增加.
结论:
- 标准化疼痛管理命令集减少了整体产后阿片类药物使用,但没有解决疼痛评估和管理中的种族和民族差异.
- 未来的干预措施应侧重于以种族平等为中心的教育和消除疼痛管理中的这些差异的战略.
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