通过增加对外围IV的局部麻醉剂的使用来减少住院患者的疼痛
Emilee C Lewis1, Stephanie Komkov2, Jenny Rickles2
1From the Division of Pediatric Hospital Medicine, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, N.C.
在小儿外周静脉输入管 (PIV) 放置时,局部麻醉剂的使用显著增加,减少了针头疼痛. 这一举措通过加强护理实践和合作,改善了患者的舒适性和护理.
科学领域:
- 儿科疼痛管理 儿科疼痛管理
- 基于证据的护理实践
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 静脉接入程序,如外周静脉输入管 (PIV) 放置,是住院患者常见的疼痛来源.
- 局部麻醉剂可以有效地减少针头疼痛,提高手术成功率,减少手术时间,但在PIV放置之前使用它们是不一致的.
- 需要标准化和增加用于儿科PIV安置的局部麻醉剂的使用,以提高患者的舒适性.
研究的目的:
- 为了减少接受PIV安置的住院儿科患者经历的疼痛.
- 在6个月内,将PIV安置的局部麻醉剂的利用率从基线平均11%提高到40%的目标.
主要方法:
- 改善模式的实施框架.
- 开发一个机构临床途径和一个PIV订单面板,预先检查了局部麻醉剂的订单.
- 利用视觉辅助工具,护士反,并通过统计过程控制图表和日常聚会共享数据,以促进坚持和意识.
主要成果:
- 对PIV安置的局部麻醉剂使用量从平均11%增加到46%,超过了目标目标.
- 在PIV安置期间对舒适度措施的文档从6%增加到13%.
- 用电子健康记录订购局部麻醉剂的PIV安置的百分比从14%上升到54%,记录的安置尝试从47%上升到70%.
结论:
- 系统和文化变化成功地提高了儿童PIV安置局部麻醉剂的意识和使用.
- 该倡议通过加强护士,提供者和家庭在静脉接入规划中的合作,改善了以患者为中心的护理.
- 标准化的协议和持续的反是有效的改善疼痛管理在常见的儿科手术过程中.
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