Clark Lauren, Fink Regina, Pennington Karen, Jones Katherine
University of Colorado at Denver and Health Sciences Center School of Nursing, 4200 East Ninth Avenue, Denver, CO 80262, USA.
Pain Manag Nurs. 2006 Jun;7(2):71-7. doi: 10.1016/j.pmn.2006.02.004.
Achieving optimal and safe pain-management practices in the nursing home setting continues to challenge administrators, nurses, physicians, and other health care providers. Several factors in nursing home settings complicate the conduct of clinical process improvement research. The purpose of this qualitative study was to explore the perceptions of a sample of Colorado nursing home staff who participated in a study to develop and evaluate a multifaceted pain-management intervention. Semistructured interviews were conducted with 103 staff from treatment and control nursing homes, audiotaped, and content analyzed. Staff identified changes in their knowledge and attitudes about pain and their pain-assessment and management practices. Progressive solutions and suggestions for changing practice include establishing an internal pain team and incorporating nursing assistants into the care planning process. Quality improvement strategies can accommodate the special circumstances of nursing home care and build the capacity of the nursing homes to initiate and monitor their own process-improvement programs using a participatory research approach.
在疗养院环境中实现最佳且安全的疼痛管理实践，仍然对管理人员、护士、医生及其他医疗服务提供者构成挑战。疗养院环境中的若干因素使临床流程改进研究的开展变得复杂。这项定性研究的目的是探究参与一项旨在开发和评估多方面疼痛管理干预措施研究的科罗拉多州疗养院工作人员样本的看法。对来自治疗组和对照组疗养院的103名工作人员进行了半结构化访谈，进行了录音并做了内容分析。工作人员指出了他们在疼痛知识、态度以及疼痛评估和管理实践方面的变化。改变实践的渐进性解决方案和建议包括组建内部疼痛管理团队，并将护理助理纳入护理计划流程。质量改进策略可以适应疗养院护理的特殊情况，并利用参与式研究方法，增强疗养院启动和监督自身流程改进项目的能力。
