胸外科手术成年患者术后疼痛的评估和管理: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 : 2024-07-17 DOI:10.1097/XEB.0000000000000449
Delia González de la Cuesta, Esther González María, Nieves López Ibort, Ana Carmen Lahuerta Martínez, Isabel de la Torre Arrieta, Ana Sofía Martínez Mompel, M Pilar Martín Ramo, Eva Belsue Cortés, Mariana Monge Nieto, Cristina Cayón Geli, Mercedes Nuria Ferrando Margeli
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引用次数: 0

摘要

导言和目标:有效控制术后疼痛可以改善患者的状况,缩短住院时间。这反过来又会对护理人员、专业人员和医疗机构产生影响,因此被视为衡量医疗质量的首要指标。本项目旨在改善胸外科患者手术后疼痛的评估和管理:该实施项目在西班牙一家三甲医院的胸外科进行。该项目以 JBI 证据实施框架为指导,该框架以审核、反馈和再审核策略为基础。对 44 名患者进行了基线审核,并确定了最佳实践的障碍。随后,实施了改进术后疼痛评估和管理的策略。采用九项审核标准对 34、40 和 46 名患者分别进行了三次后续审核:结果:基线审核结果显示,最佳实践的合规性较差。在针对不符合标准的地方实施了相关策略后,对患者和护理人员的健康教育提高到了 80%,而入院时和手术后的疼痛测量提高到了 91%。然而,接受术前评估以指导出院时术后疼痛管理的患者仍低于 50%:结论:采用一种方法来实施最佳实践,再加上临床审核,可以提高使用有效量表来评估和管理疼痛的依从性。多学科方法提高了患者接受护理的质量,有助于他们的康复。西班牙文摘要:http://links.lww.com/IJEBH/A240。
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Assessment and management of post-surgical pain in adult patients undergoing thoracic surgery: a best practice implementation project.

Introduction and objectives: Effectiv. e management of post-operative pain improves the condition of patients and reduces their hospital stay. This, in turn, has an impact on caregivers, professionals, and institutions and, as such, is considered a primary indicator of quality. The aim of this project was to improve the assessment and management of post-surgical pain in thoracic surgery patients.

Methods: This implementation project was conducted in a thoracic surgery unit of a tertiary hospital in Spain. The project was guided by the JBI Evidence Implementation Framework, which is grounded in an audit, feedback, and re-audit strategy. A baseline audit was conducted with 44 patients, and barriers to best practice were identified. Strategies were then implemented to improve the assessment and management of post-operative pain. Three follow-up audits were performed using nine audit criteria with 34, 40, and 46 patients, respectively.

Results: The baseline audit revealed poor compliance with best practices. After implementing strategies to address areas of non-compliance, health education for patients and caregivers improved up to 80%, while the measurement of pain upon admission and post-surgery rose to 91%. However, patients undergoing pre-operative assessment to guide their post-operative pain management at hospital discharge remained below 50%.

Conclusions: Using a methodology to implement best practices, together with clinical audits, improved compliance with the use of validated scales to assess and manage pain. A multidisciplinary approach improves the quality of care received by patients and contributes to their recovery.

Spanish abstract: http://links.lww.com/IJEBH/A240.

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3.20
自引率
13.00%
发文量
23
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