外科实习医生：培训干预前后开具阿片类药物处方的准备情况。
Surgical interns: Preparedness for opioid prescribing before and after a training intervention.
机构信息
Department of Surgery, Northwestern University, Chicago, IL, USA.
出版信息
Am J Surg. 2018 Feb;215(2):238-242. doi: 10.1016/j.amjsurg.2017.11.017. Epub 2017 Nov 20.
INTRODUCTION
Exposure to pain management curriculum in medical school is currently variable. This paper reports on formal prescribing education, self-perceived prescribing readiness, and prescribing practices among incoming surgical residents before and after a pain management training session.
METHODS
Pre-residency survey of thirty surgical interns at a single urban medical center, followed by a repeat survey after an educational session on prescription writing and opioid abuse.
RESULTS
Thirty-three percent of respondents had formal education on prescription writing in medical school. Median subjective preparedness to write an opioid prescription was 1.5 (range 1-10) on a 1-10 Likert scale. Ranges of morphine milligram equivalents (MME) prescribed varied from 420-2700 MME for 8 mock surgical scenarios. Post-training, median subjective preparedness increased to 3.5 (range 1-6) and prescription accuracy (the inclusion of a medication, dose, frequency, and duration) improved from 75% to 97% (p < 0.001). Overall, 90% of interns found the training session useful.
CONCLUSION
Most surgical interns were not trained in prescribing narcotics in medical school. Improved pain management curriculum is necessary to assure safe and consistent opioid prescriptions.
简介
目前，医学院的疼痛管理课程的教学情况存在差异。本文报告了一项针对即将入职的外科住院医师在接受疼痛管理培训前后的正式处方教育、自我感知的处方准备情况和处方实践情况的研究。
方法
在一家城市医疗中心对 30 名外科实习医生进行了入职前调查，然后在进行了关于处方书写和阿片类药物滥用的教育课程后，再次进行了调查。
结果
33%的受访者在医学院接受过处方书写方面的正规教育。在 1-10 的李克特量表上，中位数主观准备开具阿片类药物处方的评分为 1.5（范围 1-10）。8 个模拟手术场景中开具的吗啡毫克当量（MME）范围从 420-2700 MME 不等。培训后，中位数主观准备度增加到 3.5（范围 1-6），处方准确性（包括药物、剂量、频率和持续时间）从 75%提高到 97%（p<0.001）。总体而言，90%的实习医生认为培训课程很有用。
结论
大多数外科实习医生在医学院没有接受过开具麻醉性镇痛药的培训。需要改进疼痛管理课程，以确保安全和一致的阿片类药物处方。
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