Reichert Ryan J, Gothard M David, Schwartz Hamilton P, Bigham Michael T
Pediatric Resident, Akron Children's Hospital, Akron, OH.
Statitician, BIOSTATS, Inc, East Canton, OH.
Air Med J. 2016 Nov-Dec;35(6):344-347. doi: 10.1016/j.amj.2016.07.001. Epub 2016 Oct 25.
The purpose of this study is to determine the rate of pain assessment in pediatric neonatal critical care transport (PNCCT). The GAMUT database was interrogated for an 18-month period and excluded programs with less than 10% pediatric or neonatal patient contacts and less than 3 months of any metric data reporting during the study period. We hypothesized pain assessment during PNCCT is superior to prehospital pain assessment rates, although inferior to in-hospital rates. Sixty-two programs representing 104,445 patient contacts were analyzed. A total of 21,693 (20.8%) patients were reported to have a documented pain assessment. Subanalysis identified 17 of the 62 programs consistently reporting pain assessments. This group accounted for 24,599 patients and included 7,273 (29.6%) neonatal, 12,655 (51.5%) pediatric, and 4,664 (19.0%) adult patients. Among these programs, the benchmark rate of pain assessment was 90.0%. Our analysis shows a rate below emergency medical services and consistent with published hospital rates of pain assessment. Poor rates of tracking of this metric among participating programs was noted, suggesting an opportunity to investigate the barriers to documentation and reporting of pain assessments in PNCCT and a potential quality improvement initiative.
本研究的目的是确定儿科新生儿重症监护转运（PNCCT）中的疼痛评估率。对GAMUT数据库进行了为期18个月的查询，排除了儿科或新生儿患者接触率低于10%以及在研究期间任何指标数据报告少于3个月的项目。我们假设PNCCT期间的疼痛评估优于院前疼痛评估率，尽管低于院内评估率。对代表104445次患者接触的62个项目进行了分析。共有21693名（20.8%）患者被报告有记录在案的疼痛评估。亚分析确定62个项目中有17个持续报告疼痛评估。该组包括24599名患者，其中新生儿7273名（29.6%）、儿科患者12655名（51.5%）、成人患者4664名（19.0%）。在这些项目中，疼痛评估的基准率为90.0%。我们的分析显示该比率低于紧急医疗服务机构，且与已公布的医院疼痛评估率一致。注意到参与项目中该指标的跟踪率较低，这表明有机会调查PNCCT中疼痛评估记录和报告的障碍以及潜在的质量改进举措。
