通过评估改善重症监护室的疼痛管理
Reidun K N M Sandvik1, Maida Mujakic2, Ingvild Haarklau2
1Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway; Centre for Care Research, West, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
概括
实施关键护理疼痛观察工具 (CPOT) 增加了护士在ICU的疼痛评估. 虽然坚持是温和的,但该工具通过患者的行为改善了疼痛识别,尽管需要进一步的步骤来进行全面的疼痛管理.
科学领域:
- 关键护理医学 关键护理医学
- 护理实践 护理实践
- 疼痛管理 疼痛管理
背景情况:
- 重症监护病房 (ICU) 的患者因疾病和手术而感到疼痛.
- 在非通讯性患者中评估疼痛是具有挑战性的,有可能导致治疗不足或过度.
- 不充分的疼痛评估实践可能导致患者的治疗不够理想.
研究的目的:
- 评估实施关键护理疼痛观察工具 (CPOT) 对护士疼痛文档的影响.
- 评估在CPOT实施后对止痛和镇静剂的变化.
主要方法:
- 量化前后设计研究.
- 涉及60个患者记录 (30个实施前,30个实施后) 在大学医院的ICU.
- 使用关键护理疼痛观察工具 (CPOT) 进行疼痛评估.
主要成果:
- 在实施后,护士的疼痛评估显著增加,从每班1.3增加到2.3.
- 通过面部表情,肌肉紧张和呼吸机合作 (p=.014),CPOT使用改善了疼痛的识别.
- 降醇的使用量从CPOT前的8%增加到CPOT后的17% (p<.01).
结论:
- 实施CPOT增强了疼痛评估频率和患者行为解释.
- 护士的执法率 (38%) 表明需要不断改进实践.
- 有效的疼痛管理需要将CPOT与非药物和药物干预和重新评估相结合.
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