Laurie Collins, BSN, RN, Primary Nurse, Orthopedic and Obstetrics Inpatient Units, Flagler Hospital, St. Augustine, FL.
Denise M. Cata, RN, RN-BC, Assistant Nurse, Orthopedic Inpatient Unit, Flagler Hospital, St. Augustine, FL; and Staff nurse, Tennova Healthcare-Harton, Tullahoma, TN.
Orthop Nurs. 2020 Sep/Oct;39(5):324-332. doi: 10.1097/NOR.0000000000000697.
Orthopedic surgical patients have reported significantly lower numeric pain scores using a Wi-Fi oral patient-controlled analgesia (PCA) device compared to patients receiving oral as-needed (PRN) medication by manual administration. More than 90% of nurses using the oral PCA device have agreed that the device saved them time. The manual administration of PRN pain medication is frequently delayed and consumes a significant amount of nursing time. Delays in PRN pain medication delivery have been classed as missed nursing care, called an error of omission.
The purpose of this timing study was to examine if the use of the oral PCA device would reduce the nursing time to accomplish the delivery of PRN oral pain medication compared to the manual administration by nursing staff.
Each total task for the manual and device administration of a single PRN delivery of an oral pain medication was divided into subtasks. Personal data assistant (PDA) devices were programmed to enable the collection of timing data for each subtask for both methods.
The manual administration time was 12.7 minutes per single dose beginning with the patient medication request and ending with pain reassessment. The oral PCA device steps to program the device, deliver one of eight doses of medication, and discharge the patient from the device required 2.06 minutes of nursing time. Reloading an additional eight-dose tray required 40 seconds of nursing time per dose of medication administered.
The oral PCA saved 84% of the nursing time to administer each dose of PRN medication manually. These data provide evidence that the oral PCA device would reduce the nursing time to deliver a single dose of PRN oral pain medication.
与接受手动按需（PRN）药物治疗的患者相比，骨科手术患者使用 Wi-Fi 口腔患者自控镇痛（PCA）设备报告的数字疼痛评分显著降低。超过 90%使用口腔 PCA 设备的护士都认为该设备为他们节省了时间。PRN 疼痛药物的手动管理经常延迟，消耗大量护理时间。PRN 疼痛药物给药的延迟被归类为遗漏的护理，称为遗漏错误。
本时间研究的目的是检查与护理人员手动给药相比，使用口腔 PCA 设备是否会减少完成 PRN 口服疼痛药物给药所需的护理时间。
将手动和设备管理单次 PRN 口服疼痛药物给药的每个总任务分为子任务。个人数字助理（PDA）设备经过编程，能够为两种方法的每个子任务收集计时数据。
从患者用药请求开始到疼痛重新评估结束，每次单剂量的手动给药管理时间为 12.7 分钟。为患者编程设备、给予八剂药物中的一剂并将患者从设备中释放所需的口腔 PCA 设备步骤需要 2.06 分钟的护理时间。每次给药额外的八剂量托盘需要 40 秒的护理时间。
口腔 PCA 节省了手动管理每个 PRN 剂量药物所需护理时间的 84%。这些数据提供了证据，表明口腔 PCA 设备将减少单次 PRN 口服疼痛药物的给药护理时间。
