Boerlage Anneke A, Masman Anniek D, Hagoort Jacobus, Tibboel Dick, Baar Frans P M, van Dijk Monique
Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
Pain Manag Nurs. 2013 Mar;14(1):36-40. doi: 10.1016/j.pmn.2010.05.003. Epub 2010 Jul 24.
Quality of care gains transparency with the help of performance indicators. For Dutch nursing homes, the current set of performance indicators does not include pain. To determine the feasibility of pain assessment as performance indicator, information about pain prevalence and analgesic prescription in one nursing home was collected. Within the time span of 3 days, pain intensity was measured in 91% of the residents (201 out of 221), either with a numeric rating scale, a verbal rating scale, or the Rotterdam Elderly Pain Observation Scale (REPOS). Numerical rating was used for 72%, verbal rating for 3%, and REPOS observation for 25% of the residents. Pain was substantial in 65 residents (32%), who received the following analgesic prescription: World Health Organization (WHO) step 1, 45%; WHO step 3, 12%; and neuroactive agents, 5%. Thirty-eight percent of these residents were in pain and received no analgesics. Residents with substantial pain significantly more often received analgesics (p = .007). Results suggest that pain assessment is feasible in a nursing home and would stimulate staff attention to pain. Further investigation is necessary to find out if a pain algorithm is feasible and will lead to improved pain treatment.
在绩效指标的帮助下，护理质量变得更加透明。对于荷兰的养老院来说，当前的绩效指标集并不包括疼痛方面。为了确定将疼痛评估作为绩效指标的可行性，收集了一家养老院中有关疼痛患病率和镇痛处方的信息。在3天的时间跨度内，对91%的居民（221人中的201人）进行了疼痛强度测量，测量方法包括数字评分量表、语言评分量表或鹿特丹老年疼痛观察量表（REPOS）。72%的居民使用数字评分，3%使用语言评分，25%使用REPOS观察。65名居民（32%）存在中度疼痛，他们接受了以下镇痛处方：世界卫生组织（WHO）第1阶梯，45%；WHO第3阶梯，12%；神经活性药物，5%。这些居民中有38%处于疼痛状态但未接受任何镇痛药治疗。存在中度疼痛的居民更常接受镇痛药治疗（p = 0.007）。结果表明，在养老院进行疼痛评估是可行的，并且会促使工作人员关注疼痛。有必要进行进一步调查，以确定疼痛算法是否可行以及是否会改善疼痛治疗。
