Carlson Cathy L
School of Nursing, Northern Illinois University, DeKalb, Illinois 60115, USA.
Pain Manag Nurs. 2009 Dec;10(4):174-87. doi: 10.1016/j.pmn.2008.07.001. Epub 2009 Feb 28.
To provide optimal postoperative pain relief, nursing practice should be based on the best evidence available. For over 20 years, results of studies regarding nurses' use of evidence-based practices, including postoperative pain assessment practices, have shown that nurses use the practices inconsistently. The present cross-sectional survey study was conducted to: 1) determine the extent to which registered nurses caring for postoperative patients experiencing pain used three evidence-based postoperative pain assessment practices; and 2) identify relationships among the level of adoption of evidence-based postoperative pain assessment practices and selected characteristics of registered nurses. Data were collected from a convenience sample of all nurses caring for adult postoperative patients in two Midwestern hospitals where 443 surveys (46.9%) were returned. Respondents were aware of, but not using, three evidence-based postoperative pain assessment practices consistently. Registered nurses who used multiple sources to identify solutions to clinical practice problems or read one or two professional journals regularly were more likely to have adopted the three evidence-based postoperative pain assessment practices. Registered nurses need to be encouraged to use multiple sources to identify solutions to clinical practice problems, including professional nursing journals. Innovative approaches to promote the application of research to education and practice settings are needed. It is important to identify opinion leaders, because opinion leaders are an important resource in overcoming the barriers so that adoption of pain of evidence-based postoperative pain assessment practices can proceed. Additional research is needed to identify what variables effect the adoption of evidence-based practices and identify interventions to improve the level of adoption.
为了提供最佳的术后疼痛缓解,护理实践应基于现有的最佳证据。二十多年来,关于护士使用循证实践(包括术后疼痛评估实践)的研究结果表明,护士对这些实践的使用并不一致。本横断面调查研究的目的是:1)确定护理术后疼痛患者的注册护士使用三种循证术后疼痛评估实践的程度;2)确定循证术后疼痛评估实践的采用水平与注册护士的选定特征之间的关系。数据来自美国中西部两家医院所有护理成年术后患者的护士的便利样本,共收回443份调查问卷(46.9%)。受访者知晓但未始终如一地使用三种循证术后疼痛评估实践。使用多种来源确定临床实践问题解决方案或定期阅读一两种专业期刊的注册护士更有可能采用三种循证术后疼痛评估实践。需要鼓励注册护士使用多种来源确定临床实践问题的解决方案,包括专业护理期刊。需要创新方法来促进研究在教育和实践环境中的应用。识别意见领袖很重要,因为意见领袖是克服障碍的重要资源,这样循证术后疼痛评估实践的采用才能推进。需要进行更多研究,以确定哪些变量影响循证实践的采用,并确定提高采用水平的干预措施。