ICU护士对危重患者疼痛护理相关知识与实践现状的分析

ICU nurses' knowledge and practice of pain management for critically ill patients

为了了解ICU护士对危重患者疼痛相关知识的掌握与实践现状,对某三级甲等医院129名ICU护士进行了调查。结果显示,ICU护士疼痛知识与态度调查平均正确率为35.2%;参加过疼痛学习班、有疼痛处理经验者回答正确率较高(P<0.05)。大多数ICU护士(76.7%)使用过疼痛强度评估量表,但无人使用过行为观察疼痛评估工具。ICU护士选择最能代表危重患者存在疼痛的行为是痛苦表情(66.7%)、皱眉(48.8%)和握紧拳头(46.5%)等。ICU护士认为积极的ICU团队、标准化疼痛评估工具及持续疼痛教育等是危重患者疼痛护理的重要促进因素,患者不能交流、缺少疼痛指南及评估工具、工作量大等是主要障碍因素。应强化对ICU护士的疼痛教育,鼓励应用行为指征对危重患者进行疼痛评估,营造良好的疼痛治疗护理环境,持续改进疼痛护理质量。

To investigate ICU nurses＇ knowledge and practice of pain management for critically ill patients,totally 129 ICU nurses in a tertiary first class hospital were investigated with Pain Knowledge and Attitude Survey. The average correct rate of knowledge of pain was 35.2%. The correct rate was significantly higher in nurses who received training or had experience in pain management（P〈O.05）. The majority of ICU nurses（76.7%） had experience of using pain intensity assessment scales,but none of them had used observational pain assessment tools. Behaviors most frequently selected as indicators of pain were wincing （66.7%）, frowning （48.8%） and clenching fists （46.5%）. Active ICU team, standardized pain assessment tools and ongoing pain edu-cation were considered as the key facili- tators to pain management, while patients unable to communicate, lack of pain guidelines and assessment tools ,and heavy workload were major barriers. In order to continuously improve the quality of pain management, it is suggested to provide pain education for ICU nurses, encourage them to assess pain based on patients＇ behavioral indicators and create a healthy work environment for pain management.