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急性病房中外科创伤患者的术后疼痛管理:一项最佳实践实施项目。

Post-operative pain management among surgical trauma patients in an acute ward: a best practice implementation project.

作者信息

García-Monasterio Emilia Irene, Alvárez-Vázquez Juan Carlos, Morado-Quiñoá Purificación, Pena-Pena Amparo, Mazón Mar Folgueira, Bouso Ana Murado, López Angeles Landeira, Cendán-Celeiro Elena

机构信息

Trauma Unit, Lucus Augusti University Hospital, Lugo, Spain.

The Spanish Centre for Evidence Based Nursing and Healthcare: a Joanna Briggs Institute Centre of Excellence.

出版信息

JBI Database System Rev Implement Rep. 2019 Sep;17(9):1941-1953. doi: 10.11124/JBISRIR-2017-003916.

Abstract

INTRODUCTION

Effective pain management should be one of the main goals of healthcare professionals. The trauma unit of a hospital in an urban area of Spain carried out an implementation project, guided by the evidence-based criteria from JBI, to put in place the processes and initiatives needed to reduce post-operative pain.

OBJECTIVES

The aim of this implementation project was to promote evidence-based practice in managing post-operative pain.

METHODS

A pre-post implementation audit was implemented using the JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) tool. Each audit included 30 post-operative patients from a randomized sample who were evaluated before the project started and six months after key strategies had been implemented. The criteria were audited according to evidence-based process criteria.

RESULTS

At the baseline audit, the compliance percentages for the evidence-based criteria ranged from 10% to 43%. Seven obstacles were identified in relation to post-operative pain management. Following the GRiP table, the team established a series of strategies and resources to implement the improvement actions. When the implementation period ended, all the criteria had improved.

CONCLUSIONS

The quality improvement cycle allowed us to implement the clinical best practice recommendations, with subsequent outcome improvements for patients. Future audits should be performed to drive new cycles of improvement in evidence-based practice.

摘要

引言

有效的疼痛管理应是医疗保健专业人员的主要目标之一。西班牙一个市区医院的创伤科开展了一个实施项目,以循证医学中心(JBI)的循证标准为指导,落实减轻术后疼痛所需的流程和举措。

目的

该实施项目的目的是在术后疼痛管理中推广循证实践。

方法

使用循证医学中心的临床证据系统实际应用(PACES)和将研究成果应用于实践(GRiP)工具进行实施前和实施后的审核。每次审核都包括从随机样本中抽取的30名术后患者,这些患者在项目开始前以及关键策略实施六个月后接受评估。依据循证流程标准对各项标准进行审核。

结果

在基线审核中,循证标准的合规率在10%至43%之间。确定了与术后疼痛管理相关的七个障碍。根据GRiP表,团队制定了一系列策略和资源以实施改进措施。当实施期结束时,所有标准都有所改善。

结论

质量改进循环使我们能够实施临床最佳实践建议,从而使患者的后续结果得到改善。应进行未来审核,以推动循证实践的新改进循环。

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