Spence Kaye, Henderson-Smart David, New Karen, Evans Cheryl, Whitelaw Jan, Woolnough Rowena
Centre for Perinatal Health Services Research, University of Sydney, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2010 Apr;46(4):184-92. doi: 10.1111/j.1440-1754.2009.01659.x. Epub 2010 Jan 26.
To facilitate the uptake of evidence and to reduce the evidence practice gap for management of newborn pain through the development of a clinical practice guideline.
An audit of practice and an appraisal of clinical practice guidelines were undertaken to establish current practices and guideline availability for the management of newborn pain in 23 hospitals in Australia. Guidelines were appraised using the Appraisal of Guidelines for Research and Evaluation instrument. A literature search was undertaken to acquire the evidence for best practice for management of newborn pain.
Neonatal units in 17 hospitals had clinical practice guidelines. Each was peer reviewed and assessed according to the domains of the Appraisal of Guidelines for Research and Evaluation instrument. There was lack of consistency across the guidelines. As a result, a best practice guideline was developed based on current best evidence and the Royal Australian College of Physicians recommendations. To facilitate an ongoing compliance with the guideline, an audit tool was included together with algorithms for procedural pain and pain assessment.
The clinical practice guideline can be used by clinicians in varying settings such as the neonatal intensive care and special care unit. The document can be used to support existing practices or challenge clinicians to close the evidence practice gap for the management of newborn pain.
通过制定临床实践指南,促进对证据的采纳,并缩小新生儿疼痛管理方面的证据与实践差距。
对澳大利亚23家医院新生儿疼痛管理的实践进行审核,并对临床实践指南进行评估,以确定当前的实践情况和指南的可获取性。使用《研究与评价指南评估工具》对指南进行评估。进行文献检索以获取新生儿疼痛管理最佳实践的证据。
17家医院的新生儿病房有临床实践指南。根据《研究与评价指南评估工具》的领域对每个指南进行同行评审和评估。各指南之间缺乏一致性。因此,基于当前的最佳证据和澳大利亚皇家内科医师学院的建议制定了最佳实践指南。为促进持续遵守该指南,纳入了一个审核工具以及程序性疼痛和疼痛评估的算法。
临床实践指南可供新生儿重症监护病房和特殊护理病房等不同环境中的临床医生使用。该文件可用于支持现有实践,或促使临床医生缩小新生儿疼痛管理方面的证据与实践差距。