急性病房外科创伤患者术后疼痛管理:循证实践实施项目。

Emilia Irene García-Monasterio, Juan Carlos Alvárez-Vázquez, Purificación Morado-Quiñoá, Amparo Pena-Pena, M. Mazón, Ana Murado Bouso, Angeles Landeira López, Elena Cendán-Celeiro
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引用次数: 3

摘要

有效的疼痛管理应该是医疗专业人员的主要目标之一。西班牙某城市地区一家医院的创伤科在JBI的循证标准指导下开展了一个实施项目,以落实减少手术后疼痛所需的程序和举措。目的本实施项目的目的是促进以证据为基础的治疗术后疼痛。方法采用JBI临床证据系统的实际应用(PACES)和将研究付诸实践(GRiP)实施实施前后审计方法。每次审计包括30名随机抽样的术后患者,在项目开始前和关键策略实施后6个月对他们进行评估。这些标准是根据循证过程标准进行审核的。结果基线审计中,循证标准的符合率为10% ~ 43%。确定了与术后疼痛管理有关的七个障碍。根据GRiP表,团队建立了一系列策略和资源来实施改进行动。在执行期结束时,所有标准都有所改善。结论质量改进周期使我们能够实施临床最佳实践建议,并随后改善患者的预后。未来的审计应该在循证实践中推动新的改进周期。
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Post-operative pain management among surgical trauma patients in an acute ward: an evidence-based practice implementation project.
INTRODUCTION Effective pain management should be one of the main goals of healthcare professionals. The trauma unit of a hospital in an urban area of Spain carried out an implementation project, guided by the evidence-based criteria from JBI, to put in place the processes and initiatives needed to reduce post-operative pain. OBJECTIVES The aim of this implementation project was to promote evidence-based practice in managing post-operative pain. METHODS A pre-post implementation audit method was implemented using the JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP). Each audit included 30 post-operative patients from a randomized sample who were evaluated before the project started and six months after key strategies had been implemented. The criteria were audited according to evidence-based process criteria. RESULTS At the baseline audit, the compliance percentages for the evidence-based criteria ranged from 10% to 43%. Seven obstacles were identified in relation to post-operative pain management. Following the GRiP table, the team established a series of strategies and resources to implement the improvement actions. When the implementation period ended, all the criteria had improved. CONCLUSIONS The quality improvement cycle allowed us to implement the clinical best practice recommendations, with subsequent outcome improvements for patients. Future audits should be performed to drive new cycles of improvement in evidence-based practice.
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