实施疼痛管理检查清单,以改善成人外科患者的术后疼痛
Sophie Cameron1, Anastasia Lusnia1, Tyrell Roberson1
1University of South Florida, School of Nursing, Tampa, FL.
概括
一个质量改进项目实施了一份疼痛管理清单,以减少术后疼痛. 虽然在PACU到达时的疼痛得分有所改善,但离院疼痛得分没有,这表明需要进一步干预.
科学领域:
- 提高质量 提高质量
- 疼痛管理 疼痛管理
- 外科手术的结果
背景情况:
- 有效的术后疼痛管理对于患者的结果和满意度至关重要.
- 术后疼痛显著影响患者的康复和体验.
- 需要标准化的协议来优化在麻醉后护理单位 (PACU) 的疼痛管理.
研究的目的:
- 实施疼痛管理检查清单,以减少PACU的手术后疼痛.
- 在四个手术群体中评估PAIN管理检查清单的有效性.
- 降低在二级医院接受特定手术的患者中术后疼痛评分.
主要方法:
- 计划-做-研究-行动 (PDSA) 质量改进模型指导了该项目.
- 包括接受非椎脊柱,妇科,前列腺切除和探索性腹腔切除手术的成年患者.
- 追溯图表审查比较疼痛得分 (数值评分表) 之前和之后的检查清单实施.
主要成果:
- 在PACU到达时,平均疼痛评分从1.66降至1.29 (P = .03).
- 然而,PACU放出后的平均疼痛分数从1.94增加到2.21 (P = .008).
- 总共分析了1584个病例 (813个实施前,771个实施后).
结论:
- 疼痛管理检查清单在PACU到达时改善了疼痛评分.
- 检查清单并没有导致PACU出院后疼痛得分的改善.
- 未来的QI周期应该专注于预防性止痛和PACU疼痛管理策略.
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