疼痛评估管理指标提高疼痛评估完整率的临床应用

Clinical application of improving the integrity rate of pain assessment based on pain assessment management indicators

目的:探讨建立疼痛评估管理指标提高护士执行疼痛评估完整率的临床应用效果。方法:建立疼痛评估管理指标,制定护士执行疼痛评估完整检查表及细则。2017年3月至2018年2月我院对全院临床科室各层次护士进行循环式疼痛评估管理培训,取得了初步的效果。为提高护士执行疼痛评估的完整率,从2018年10月起逐步在疼痛相关科室(骨科、肿瘤科、烧伤科、胸外科、产科、麻醉科、小儿科等)建立疼痛评估管理指标,选取疼痛科2018年4月至2018年9月建立疼痛评估管理指标前住院病人500例作为对照组,选取疼痛科2018年10月至2019年3月建立疼痛评估管理指标后的住院病人500例作为试验组,将护士执行疼痛评估的完整率、疼痛强度评估的准确率、病人平均住院日及病人满意度等结果进行分析比较。结果:建立疼痛评估管理指标后护士执行疼痛评估的完整率显著、疼痛强度评估的准确率高于实施前,病人满意度提高,差异较实施前有统计学意义(P<0.01);病人平均住院天数减少,但差异无统计学意义。结论:疼痛评估管理指标的建立能有效提高护理人员参与疼痛评估管理意识,正确认识疼痛评估规范性对于病人疼痛管理的重要性,使护士执行疼痛评估完整率、疼痛强度评估准确率得到显著提高,更加规范临床疼痛评估工作,提升疼痛护理质量,减轻病人疼痛,提高病人满意度和生活质量。

Objective:To explore the clinical effect of establishing pain assessment management index to improve the integrity rate of pain assessment performed by nurses.Methods:The management index of pain assessment,and the complete examination table and detailed rules of pain assessment for nurses were established.From March 2017 to February 2018,our hospital conducted circular pain assessment and management training for nurses at all levels in clinical departments of the hospital,and achieved preliminary results.In order to improve the integrity rate of pain assessment performed by nurses,pain assessment management indicators were gradually established in pain-related departments(orthopaedics,oncology,burn department,thoracic surgery,obstetrics,anesthesiology,pediatrics,etc.)from October 2018.Five hundreds inpatients in the pain department before the establishment of pain assessment management indicators from April 2018 to September 2018 were selected as control.A total of 500 inpatients in the pain department were selected as the experimental group after the pain assessment management index was established from October 2018 to March 2019.The results of nurses'complete rate of pain assessment,accuracy of pain intensity assessment,average hospital stay and patient satisfaction were analyzed and compared.Results:After the establishment of pain assessment management indicators,the nurse's complete rate of pain assessment and the accuracy of pain intensity assessment were higher than that before implementation,and patient satisfaction improved(P<0.01);the average hospital stay of patients was decreased(the difference was not statistically significant).Conclusion:The establishment of pain assessment management index can effectively improve nurses'awareness of participating in pain assessment management and correctly understand the importance of pain evaluation standardization for patients'pain management.It can significantly improve the integrity rate of pain evaluation and the accuracy of pain intensity assessment,standardize clinical pain assessment,improve the quality of pain care,reduce patients'pain,and improve patients'satisfaction and quality of life.