妇科病房成年患者疼痛评估与管理:最佳实践实施项目。

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Jbi Evidence Implementation Pub Date : 2023-12-01 DOI:10.1097/XEB.0000000000000387
Leticia Bernués-Caudillo, Laura Albornos-Muñoz, M Paz Fernández Rodrigo, Marta Álvarez García, Marta De Rioja Benito, María Jesús Ruano Serrano, Paloma García Navarro, Patricia Ledesma Pérez, Sonia González Sotelo, M Teresa Moreno-Casbas, Tereza Vrbová, Miloslav Klugar, Jitka Klugarová, Esther Gonzalez-María
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引用次数: 0

摘要

目的:本项目旨在提高妇科病房疼痛评估和管理的循证实践依从性。引言:有效的疼痛控制对于预防管理不善的疼痛的负面后果很重要。然而,它仍然被低估,得不到充分的治疗。应用循证实践来正确评估和管理疼痛是改善疼痛缓解的必要条件。方法:本项目遵循JBI证据实施框架。对41名入住妇科病房的妇女进行了基线审计,并根据5项最佳实践标准进行了测量,同时进行了患者满意度问卷调查。然后实施有针对性的策略,并使用与基线审计相同的标准、方法和样本量进行后续审计。结果:基线审计揭示了当前和最佳实践之间的差距。确定实施的障碍,并设计和实施解决障碍的策略(护士教育、信息材料、电子病历系统改进)。全面的疼痛评估,包括动态和静态疼痛评估,有效工具的使用,以及向患者和护理人员提供的教育,在后续审计中得到改善。患者满意度没有变化;然而,护士测量的疼痛与患者测量的疼痛之间的差异减小了。结论:JBI方法有助于提高循证实践标准的依从性。它还促进了对新障碍的适应,例如COVID-19大流行。提高护士对疼痛评估的认识可以使评估更加准确。不完善的记录系统也使记录所提供的护理变得困难。随后的审计将评估可持续性,并将项目升级到其他地区。
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Pain assessment and management among adult patients in a gynecology ward: a best practice implementation project.

Objectives: This project aimed to improve compliance with evidence-based practice in pain assessment and management in a gynecology ward.

Introduction: Effective pain control is important to prevent the negative consequences of pain that is poorly managed. However, it remains undervalued and inadequately treated. Applying evidence-based practices to correctly evaluate and manage pain is essential to improve pain relief.

Methods: This project followed the JBI Evidence Implementation Framework. A baseline audit of 41 women admitted to the gynecology ward was conducted and measured against 5 best practice criteria, along with a patient satisfaction questionnaire. Targeted strategies were then implemented and a follow-up audit was conducted using the same criteria, methods, and sample size as the baseline audit.

Results: The baseline audit revealed gaps between current and best practice. Barriers to implementation were identified and strategies to resolve the barriers were designed and implemented (nurse education, informative materials, electronic patient records system improvements). Comprehensive pain assessment, including dynamic and static pain assessment, use of a validated tool, and education provided to patients and carers, improved in the follow-up audit. There was no change in patient satisfaction levels; however, the discrepancy between pain measured by nurses and pain measured by patients was reduced.

Conclusions: The JBI methodology was useful in improving compliance with evidence-based practice criteria. It also facilitated adaptation to new barriers, such as the COVID-19 pandemic. Improving nurses' knowledge of pain assessment can lead to more accurate assessment. Inadequate records systems also made it difficult to record the care that was provided. Subsequent audits will assess sustainability and the project will be escalated to other wards.

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CiteScore
3.20
自引率
13.00%
发文量
23
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