门急诊儿童伤口换药疼痛管理现状调查

Current situation of pain management of wound dressing changes with children in outpatient and emergency

目的:调查门急诊儿童伤口换药疼痛管理现状。方法:便利选取31个省、自治区、直辖市二级及以上医院门急诊伤口换药室的护理管理者,采用自行设计的调查问卷进行调查。结果:共调查了109所医院,其中91.7%的医院已成立伤口护理小组,41.3%的医院伤口换药主要由伤口专科护士完成;未开展疼痛评估、疼痛记录或疼痛健康教育的医院分别占比33.0%、34.9%、26.6%;77.1%的医院镇痛不足;儿童伤口换药疼痛管理的阻碍因素主要包括:换药人员疼痛管理知识储备不足、换药室疼痛管理机制不完善与患儿家属用药依从性低。结论:儿童伤口换药疼痛管理的组织制度较完善,具体措施有待规范,镇痛效果欠佳。建议规范疼痛管理程序,提高镇痛措施的有效性,解决疼痛管理的阻碍因素,从而改善儿童伤口换药体验。

Objective:To investigate the current situation of pain management of wound dressing changes in outpatient and emergency children.Methods:A self-designed questionnaire was applied to investigate the nursing managers of outpatient and emergency wound dressing rooms in 31 provinces.Results:A total of 109 hospitals were investigated.Totally 91.7%of the hospitals had wound care team,and 41.3%of the hospitals had specialist nurses to provide wound care.The proportion of hospitals without pain assessment,pain record or pain health education was 33.0%,34.9%and 26.6%,respectively.In 77.1%of hospitals,analgesia was insufficient.The main disadvantage of pain management were insufficient knowledge of pain management of the wound dressing staff,imperfect pain management system and low medication compliance of the family members.Conclusion:The organizational system for pain management of children's wound dressing changes is mostly effective,while the specific measures need to be standardized,and the analgesic effect need to be improved.It is recommended to standardize pain management procedures,enhance the effectiveness of analgesic measures,and solve the obstacles to pain management in order to improve the experience of wound dressing changes.