父母参与在泌尿外科患儿术后疼痛管理中的最佳证据应用

The best evidence for parental involvement in postoperative pain management in children with urology

目的将基于循证的父母参与在泌尿外科患儿术后疼痛管理的最佳证据应用于临床实践,提高父母基于证据对患儿术后疼痛管理的参与度,从而进一步缓解患儿术后疼痛情况。方法遵循JBI循证护理中心的临床证据实践应用系统的标准程序进行证据的临床应用。通过检索父母参与患儿术后疼痛管理的相关证据并制定15条审查指标。采用问卷调查法、现场观察法、访谈、查阅护理记录收集数据;分析每条证据应用存在的障碍因素和促进因素,并制定行动策略;通过审查指标执行情况、患儿术后疼痛评分、患儿术后其他指标来评价证据应用效果。结果3项审查指标在证据应用后的执行率由0提升至100%;患儿术后拆敷料时疼痛评分、拔导尿管时疼痛评分和出院时疼痛评分均在证据应用后显著降低(P<0.05)。结论在临床护理中应用基于循证的父母参与在泌尿外科患儿术后疼痛管理的最佳证据,可提高父母基于证据对患儿术后疼痛管理的参与度,并缓解泌尿外科患儿术后疼痛程度,提升患儿术后生活质量。

Objective To apply the best evidence-based parental involvement in postoperative pain management in children with urology to clinical practice,improve the parental evidence-based participation in postoperative pain management and further ease the operation after pain.Methods Evidence-based resources such as computer decision support systems,clinical practice guidelines,systematic reviews and original research were retrieved in postoperative pain-related fields.Through literature quality evaluation,1 guideline,2 evidence summaries,2 systematic reviews,and 1 meta-analysis were included as references for evidence resources.Summarize 10 pieces of evidence,evaluate through feasibility,suitability,clinical significance and effectiveness,produce 10 best pieces of evidence,and transform them into 15 clinical review indicators.Follow the standard procedures of the clinical evidence practice application system of JBI evidence-based nursing center for clinical application of evidence.Data were collected using questionnaires,on-site observations,interviews and nursing records.The effectiveness of the evidence was evaluated by reviewing the implementation of indicators and postoperative pain.Results The implementation rate of the three review indicators increased from zero to 100%after the application of the evidence.The pain scores at dressing removal,catheter removal and discharge were significantly reduced after evidence application(P<0.05).Conclusion Applying the best evidence of evidence-based parental involvement in postoperative pain management in children with urology in clinical care can improve parental involvement in evidence-based pain management in postoperative children and relieve postoperative pain in children with urology.The degree of pain improves the quality of life of children after surgery.