Erlenwein J, Meißner W, Petzke F, Pogatzki-Zahn E, Stamer U, Koppert W
Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Göttingen, Deutschland.
Klinik für Anästhesiologie und Intensivmedizin, Sektion Schmerztherapie, Universitätsklinikum Jena, Jena, Deutschland.
Anaesthesist. 2019 May;68(5):317-324. doi: 10.1007/s00101-019-0589-8.
Although pain services have been established in many hospitals, there is considerable heterogeneity among them with respect to organization of service, staff and qualifications of staff, and treatment approaches.With this recommendation, the German Society for Anesthesiology and Intensive Care Medicine defines requirements for pain services in hospitals with respect to organizational standards and staff qualifications. The therapy offered by pain services supplements the treatment provided by the other departments involved, ensuring the high quality of specialized pain management in all areas of the hospital. Pain services shall oversee treatment with specialized analgesia techniques as well as the involvement of consultants, bringing together in-hospital pain medicine expertise in one service with availability 24 h and 7 days per week via a single contact. The medical head of the pain service shall be a qualified provider of pain medicine as defined by the German Medical Association and as a minimum should also have undergone additional training in basic psychosomatic medicine. Further members of the medical staff should possess the credentials of a medical specialist: non-medical staff should have completed continuing education in the treatment of pain. Minimal guidelines for personnel resources were defined: these included a specific time frame for first contacts (20 min) and follow-up (10 min) for specific analgesic techniques and for the involvement of consultants (first contact 45 min, follow-up 20 min), with additional time for travel, set-up, training and quality management. In addition to definition of the space and equipment needed, each service should draft its own budget, and this should be adequate and plannable. Written agreements between the disciplines and transparent documentation, including patient-reported outcomes, are recommended to ensure quality. The provision of specialized pain therapy should have high priority over all disciplines or departments.
尽管许多医院都已设立了疼痛诊疗科室，但它们在服务组织、工作人员及其资质以及治疗方法等方面存在很大差异。基于此建议，德国麻醉与重症监护医学协会针对医院疼痛诊疗科室的组织标准和工作人员资质提出了要求。疼痛诊疗科室提供的治疗是对其他相关科室治疗的补充，确保医院各领域的专业疼痛管理具备高质量。疼痛诊疗科室应监督专业镇痛技术的治疗以及会诊医生的参与情况，通过单一联系点，将医院内的疼痛医学专业知识整合到一项每周7天、每天24小时可用的服务中。疼痛诊疗科室的医疗负责人应是德国医学协会定义的合格疼痛医学提供者，并且至少还应接受过基础心身医学的额外培训。其他医务人员应具备医学专科医生资质：非医务人员应完成疼痛治疗方面的继续教育。确定了人员资源的最低指导原则：包括特定镇痛技术首次联系（20分钟）和随访（10分钟）以及会诊医生参与（首次联系45分钟，随访20分钟）的具体时间框架，还要留出额外的时间用于行程、准备、培训和质量管理。除了确定所需的空间和设备外，每个科室都应制定自己的预算，且该预算应充足且可规划。建议各学科之间签订书面协议并进行透明记录，包括患者报告的结果，以确保质量。提供专业疼痛治疗应在所有学科或科室中享有高度优先权。
