用DELPHI方法和关键性分析来管理疼痛的急诊室途径
Benjamin du Sartz de Vigneulles1, Philippe Mayran2, Cassandre Follet3
1Health, Systemic, Process, (P2S), UR4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, Lyon, France. benjamin.du-sartz-de-vigneulles@etu.univ-lyon1.fr.
Scientific reports
|November 19, 2025
概括
紧急诊所 (ED) 的疼痛管理往往是不充分的. 失败模式,效应和关键性分析 (FMECA) 确定了关键的通信和协议失败,为改善患者护理提供了可操作的见解.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健管理的管理
- 患者安全 患者安全
背景情况:
- 尽管进行了广泛的研究,但不充分的疼痛管理仍然存在.
- 在急诊室 (ED) 解决治疗不足问题需要一种组织方法.
研究的目的:
- 在ED中建模患者的疼痛旅程.
- 使用故障模式,效应和关键性分析 (FMECA) 进行疼痛管理过程的风险分析.
主要方法:
- 一个专家共识的案例研究,涉及七名专家.
- 一个六步的过程,包括基于DELPHI的建模和FMECA.
- 开发一个护理途径,包括风险分类和根本原因分析.
主要成果:
- 确定了17种情况和4种重复的机制,这些情况可能导致治疗不足.
- 绘制了六种高风险情况,将沟通,决策支持和教育作为关键失败因素.
- 根源原因分析揭示了可访问的问题,这些问题可以通过具体行动来优化.
结论:
- 评估ED疼痛具有挑战性,需要个性化治疗,而不仅仅是简单的疼痛评分.
- 在高压环境中,FMECA为识别故障和制定行动计划提供了有价值的框架.
- 优化沟通,决策支持和教育可以显著改善ED疼痛管理.
相关概念视频
Analgesia and Pain Management
1.5K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
1.5K
Methods of Documentation VI: Case Management Model
839
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
839
Peripheral Artery Disease V: Postoperative Nursing Management
356
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...
356
Peripheral Artery Disease IV: Nursing Management
325
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,...
325
Ethical Dilemmas II
2.2K
Resolving an ethical dilemma in healthcare involves a systematic approach that considers every aspect of the issue, respecting both the patient's needs and values and the healthcare professional's ethical obligations. Here are potential steps to resolve an ethical dilemma:
2.2K
SBAR II: Application of SBAR
5.6K
SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
5.6K


