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[在病房急性疼痛治疗中设定标准的效果:患者和提供者满意度及成本结构参数(STANDAKU)]

[The effects of setting a standard in the acute pain therapy on a ward : Parameters for patient and provider satisfaction and cost structure (STANDAKU)].

作者信息

Bialas P, Welsch K, Gronwald B, Gottschling S, Kreutzer S, Haber M, Volk T

机构信息

Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes und Medizinische Fakultät, Universität des Saarlandes, Kirrbergerstraße 1, 66421, Homburg/Saar, Deutschland.

Zentrum für Palliativmedizin und Kinderschmerztherapie, Universitätsklinikum des Saarlandes und Medizinische Fakultät Universität des Saarlandes, Homburg/Saar, 66421, Kirrbergerstraße 1, Deutschland.

出版信息

Schmerz. 2018 Dec;32(6):449-455. doi: 10.1007/s00482-018-0330-6.

Abstract

BACKGROUND

There is neither a "gold standard" nor commonly approved therapy goals in postoperative pain therapy. In a multi-center study, more than 80% of all patients treated stated that they suffered from postoperative pain. Moreover, patients evaluated the pain therapy as significantly worse than other medical or nursing practices. Therefore, there is a need for optimization in therapy for acute pain.

OBJECTIVES

The goal of our project was to figure out if the introduction of a "pain treatment standard" would increase the satisfaction of patients, physicians, and nurses, and reduce the costs of pain-related medicine.

MATERIALS AND METHODS

Overall, 2769 patients and 285 providers (202 nurses and 83 physicians) were polled. The medication costs in ten areas of the ward were evaluated and compared. The providers were offered a training course on the "pain standard" and it was officially introduced onto the wards. After some time, the satisfaction of patients and providers and the use of medicine were recorded again.

RESULTS AND DISCUSSION

The maximum pain values declared by the patients significantly decreased after the introduction of the "pain standard." The satisfaction with pain therapy significantly increased for the patients and for the providers. The reported minimum pain values of the patients did not change significantly. The costs of pain medicine slightly increased. In general, there was a positive effect of introducing a "pain standard" for patients and providers.

摘要

背景

术后疼痛治疗既没有“金标准”,也没有普遍认可的治疗目标。在一项多中心研究中,超过80%接受治疗的患者表示他们遭受术后疼痛。此外,患者对疼痛治疗的评价明显低于其他医疗或护理措施。因此,急性疼痛治疗需要优化。

目的

我们项目的目标是弄清楚引入“疼痛治疗标准”是否会提高患者、医生和护士的满意度,并降低与疼痛相关药物的成本。

材料与方法

总共对2769名患者和285名提供者(202名护士和83名医生)进行了调查。对病房十个区域的药物成本进行了评估和比较。为提供者提供了关于“疼痛标准”的培训课程,并正式引入病房。一段时间后,再次记录患者和提供者的满意度以及药物使用情况。

结果与讨论

引入“疼痛标准”后,患者报告的最大疼痛值显著降低。患者和提供者对疼痛治疗的满意度显著提高。患者报告的最小疼痛值没有显著变化。疼痛药物成本略有增加。总体而言,引入“疼痛标准”对患者和提供者有积极影响。

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