在重症监护环境中优化疼痛管理:来自现实评估的见解
Samira Hamadeh1, Loretta Garvey1
1Institute of Health and Wellbeing, Federation University Australia, Australia.
International journal of nursing studies advances
|March 9, 2026
概括
在重症监护中实施有效的疼痛管理需要了解上下文因素. 解决社会文化,组织和专业影响可以改善护士采用基于证据的策略,并提高患者的治疗结果.
科学领域:
- 护理科学 护理科学
- 医疗保健管理的管理
- 患者安全 患者安全
背景情况:
- 在重症监护室 (ICU) 中不一致的疼痛管理导致患者的不良结果和延长住院时间.
- 有效的疼痛管理对于预防过度镇静和不充分的止痛等并发症至关重要.
- 疼痛管理策略的实施是复杂的,需要对上下文支持者,机制和利益相关者的参与进行分析.
研究的目的:
- 检查影响ICU疼痛管理干预措施实施的社会文化,组织,专业和个人因素.
- 考虑这些因素对各种利益相关者的影响.
- 为加强实施提供基于证据的建议.
主要方法:
- 进行了理论驱动的,三阶段的现实主义评估.
- 第一阶段包括范围审查和调查,以开发初始程序理论.
- 第二阶段和第三阶段涉及快速现实主义审查和利益相关者采访,以代理论改进.
主要成果:
- 实施成功取决于背景,交叉知识,权力动态和专业身份.
- 授权,道德困扰和信任等机制影响了护士采用干预措施.
- 层次结构 (生物医学,跨专业) 和组织文化可以阻碍或促进变化.
结论:
- 疼痛管理是一种社会嵌入的实践,而不仅仅是临床干预.
- 调查结果对教育工作者,政策制定者和护士领导者产生影响,以促进公平,情境敏感的实施.
- 改进的实施策略可以提高临床实践和重症监护机构的患者结果.
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