Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden.
Section of Emergency Medicine, Södersjukhuset, Stockholm, Sweden.
J Clin Nurs. 2018 Feb;27(3-4):829-835. doi: 10.1111/jocn.14125. Epub 2017 Dec 7.
To explore registered nurses' (RNs) own experience of using the nurse-initiated pain protocol (NIPP) in the emergency department (ED) based on their working experience.
Pain is known to be one of the most common symptoms among adult patients seeking care at the ED. Several strategies aiming to improve pain management have been developed. Despite some improvements in pain management using NIPP, a large number of patients continue to have inadequate pain treatment when cared for in EDs.
A cross-sectional study design based on a questionnaire was used. The variable working experience was based on a theory that experience will make a change in RNs' knowledge. Descriptive statistics and Pearson's chi-square tests were used for analysing quantative data. Qualitative data were analysed by summative content analysis.
Seventy RNs answered the questionnaire (response rate 42%) and 61% considered the NIPP adequate to relieve patients' acute pain at the ED. No significant difference was found on how the RNs used the NIPP. However, qualitative data showed that more experienced RNs adapt the NIPP according to the patients' needs in a higher extent.
A majority of the RNs consider the NIPP to be adequate to relieve patients' acute pain in the ED. An increase in working experience showed an impact on how the NIPP was used, with an increase in pain management that is personalised depending on individual patients' needs. The RNs used several alternatives to both dosage and type of medication when the ED becomes crowded.
Registered nurses' working experience should be considered when planning nursing schedules to be better able to meet patients' needs. Guidelines should be developed and evaluated by both healthcare professionals and patients.
探索注册护士（RNs）根据自身工作经验，在急诊科（ED）使用护士主导的疼痛方案（NIPP）的自身体验。
众所周知，疼痛是成年患者在急诊科就诊时最常见的症状之一。已经开发了几种旨在改善疼痛管理的策略。尽管使用 NIPP 改善了疼痛管理，但仍有大量患者在 ED 接受治疗时疼痛治疗不足。
采用基于问卷的横断面研究设计。工作经验变量基于这样一种理论，即经验将改变 RNs 的知识。使用描述性统计和 Pearson's chi-square 检验对定量数据进行分析。定性数据通过总结性内容分析进行分析。
70 名 RN 回答了问卷（应答率为 42%），61%的人认为 NIPP 足以缓解 ED 患者的急性疼痛。RNs 使用 NIPP 的方式没有发现显著差异。然而，定性数据显示，经验丰富的 RN 更能根据患者的需求调整 NIPP。
大多数 RN 认为 NIPP 足以缓解 ED 患者的急性疼痛。工作经验的增加对 NIPP 的使用方式产生了影响，根据患者的个体需求增加了个性化的疼痛管理。当 ED 变得拥挤时，RNs 会使用几种替代药物剂量和类型的方法。
在规划护理时间表时，应考虑注册护士的工作经验，以便更好地满足患者的需求。应制定和评估由医疗保健专业人员和患者共同参与的指南。
