一个质量改进项目,实施标准化疼痛评估和阿片类药物管理指南在IV级NICU
Naveed Ur Rehman Durrani1,2, Isam Abdulaziz Badhawi1, Simi Kurian1
1Department of Pediatrics, Neonatal Division, Sidra Medicine, Al Rayyan, Qatar.
Journal of neonatal-perinatal medicine
|February 20, 2025
概括
这项质量改善项目成功地将新生儿重症监护室 (NICU) 的阿片类药物使用量减少了50%以上. 标准化疼痛管理指南改善了婴儿护理,并最大限度地减少了阿片类药物戒断症状.
科学领域:
- 新生儿科学 新生儿科学
- 药理学 药理学是指药理学的学科.
- 提高质量 提高质量
背景情况:
- 管理新生儿疼痛,同时最大限度地减少阿片类药物副作用在NICU是一个临床挑战.
- 护理人员有限的认识和疼痛管理指导是重大障碍.
- 新生儿使用阿片类药物可能导致有害的副作用和戒断.
研究的目的:
- 在一年内将四级新生儿重症监护室 (NICU) 的阿片类药物使用量减少5%.
- 为新生儿实施标准化疼痛管理协议,这些新生儿需要机械通风或外科手术.
- 为了改善适当的止痛和阿片类药物相关的不良影响之间的平衡.
主要方法:
- 一个多学科团队为疼痛评估,阿片类药物启动和断奶制定了标准化指南.
- 计划,做,研究,行动 (PDSA) 方法指导了质量改进过程.
- 在干预前和干预后收集了关于阿片类药物使用 (吗啡相当于毫克/公斤) 的数据.
主要成果:
- 累积阿片类药物使用量从平均值2.7显著下降至0.85毫克/千克以下,减少超过50%.
- 断奶后没有观察到疼痛评分或阿片类药物戒断的增加,这表明适当的管理.
- 这些干预措施有效地减少了重症新生儿的整体阿片类药物暴露.
结论:
- 关于启动和断奶阿片类药物的标准化指南在减少新生儿阿片类药物暴露方面是有效的.
- 实施这些指导方针可以最大限度地减少重病新生儿的阿片类药物戒断综合征.
- 这种方法提高了患者的安全性,并优化了NICU环境中的疼痛管理.
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