Tíscar-González Verónica, Uriarte-Diaz Ana, Morales-Boiza Noelia, Linaza-Arriola Miren Bittore, García-Guevara Nieves, Izquierdo-García María Jesús
OSI Araba (Osakidetza) Vitoria, Araba, Spain.
The Spanish Centre for Evidence Based Nursing and Healthcare: a Joanna Briggs Institute Centre of Excellence.
JBI Database System Rev Implement Rep. 2019 Apr;17(4):614-624. doi: 10.11124/JBISRIR-2017-003749.
The objective of this project was to implement evidence-based recommendations for post-surgical pain management and improve quality of care for patients.
Inadequate approaches to postoperative pain can lead to the pain becoming chronic, which has an impact on the patient's quality of life. The focus of this project was to implement evidence-based recommendations to improve the effect or outcome of post-surgical pain management strategies and improve quality of care.
This implementation project was undertaken in a surgical unit of a tertiary hospital. The clinical audit was developed in three phases using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tools for promoting change in healthcare practices and improving quality of care. A baseline audit was conducted with 27 patients that identified the barriers and strategies needed to improve the assessment and management of postoperative pain. Two follow-up audits audits were conducted, each comprising 40 patients.
The baseline audit revealed the need to increase health education for patients and, or, their families on managing postoperative pain, with a special emphasis on non-pharmacological measures. This education was not recorded in the patients' medical histories at baseline and the aim was to rectify this.In follow-up audits, 100% of patients received individually tailored education about postoperative pain and its management.
The aims and main objectives of the present project were achieved, including improvements in the quality of health education related to pain and the recording of pain data. In addition, variations in the clinical practice related to the management of post-surgical pain decreased.
本项目的目的是实施基于证据的术后疼痛管理建议，并提高患者的护理质量。
术后疼痛处理方法不当会导致疼痛转为慢性，这会对患者的生活质量产生影响。本项目的重点是实施基于证据的建议，以提高术后疼痛管理策略的效果或结果，并改善护理质量。
本实施项目在一家三级医院的外科病房进行。临床审计分三个阶段开展，使用乔安娜·布里格斯循证实践中心的临床证据系统实用应用工具以及将研究成果应用于实践的审计和反馈工具，以推动医疗实践的变革并提高护理质量。对27名患者进行了基线审计，确定了改善术后疼痛评估和管理所需的障碍和策略。进行了两次随访审计，每次审计包含40名患者。
基线审计表明，需要加强对患者及其家属进行术后疼痛管理的健康教育，特别强调非药物措施。在基线时，这种教育未记录在患者的病历中，目标是纠正这一情况。在随访审计中，100%的患者接受了关于术后疼痛及其管理的个性化教育。
本项目的目标和主要目的均已实现，包括与疼痛相关的健康教育质量的提高以及疼痛数据的记录。此外，与术后疼痛管理相关的临床实践差异有所减少。
