使用临床一致疼痛评估工具的医疗-外科患者和注册护士对患者评估的满意度和全面性。

Medical-Surgical Patients' and Registered Nurses' Satisfaction and Comprehensiveness of Patient Assessment Using the Clinically Aligned Pain Assessment Tool.

机构信息

Baylor Scott & White Medical Center, Waxahachie, Texas.

出版信息

Pain Manag Nurs. 2022 Jun;23(3):293-300. doi: 10.1016/j.pmn.2021.08.003. Epub 2021 Sep 4.

DOI:10.1016/j.pmn.2021.08.003

PMID:34493438

Abstract

BACKGROUND

The pain experience is complex, and nurses are challenged to objectively assess and document patients' subjective reports of pain. There is a clear need for an assessment tool that is easy to use and provides meaningful, actionable information for patients and nurses.

AIMS

This study explored nurses' and patients' satisfaction with the Clinically Aligned Pain Assessment (CAPA) as well as nurses' charting.

SETTING AND PARTICIPANTS

A convenience sample of adult patients and nurses on four medical-surgical units in one community hospital.

METHODS

A quantitative, two-group comparison design between patients and nurses using questionnaires to determine satisfaction and a retrospective chart review to determine comprehensiveness of nurse charting.

RESULTS

No significant differences existed between patients' and nurses' responses to seven of eight satisfaction questions The median score for seven of eight questions was 5 (using a 6-point Likert scale with 1 = strongly disagree and 6 = strongly agree), which demonstrated more than 80% agreement (somewhat agree, agree, strongly agree) among both groups that CAPA was superior to the NRS, based on individual responses. The one significant difference (p = 0.03) revealed patients were more likely to respond "agree or strongly agree" compared to nurses regarding the nurse thoroughly addressing patients' needs using CAPA. Inter-rater reliability using CAPA was determined to be 89.5%, and a panel of clinical experts determined CAPA had strong content validity of 88.33%. In addition, 70.41% of nurses charted comprehensively using CAPA.

CONCLUSION

As a result, CAPA was determined to be convenient, accurate, and valuable in guiding intervention decisions.

摘要

背景

疼痛体验是复杂的，护士面临着客观评估和记录患者主观疼痛报告的挑战。显然需要一种易于使用的评估工具，为患者和护士提供有意义的、可操作的信息。

目的

本研究探讨了护士和患者对临床一致疼痛评估（CAPA）以及护士记录的满意度。

设置和参与者

在一家社区医院的四个普通外科病房，采用方便样本的成年患者和护士。

方法

使用问卷对患者和护士进行了定量、两组比较设计，以确定满意度，并对护士记录进行回顾性图表审查，以确定护士记录的全面性。

结果

在八项满意度问题中的七项，患者和护士的反应没有显著差异。八项问题中的七项的中位数评分为 5 分（使用 6 分李克特量表，1=强烈不同意，6=强烈同意），这表明两组中超过 80%的人（有些同意、同意、强烈同意）认为 CAPA 优于 NRS，基于个人的回答。唯一的显著差异（p=0.03）表明，与护士相比，患者更有可能对护士使用 CAPA 全面满足患者的需求做出“同意或强烈同意”的回应。使用 CAPA 的组内信度被确定为 89.5%，一组临床专家确定 CAPA 的内容效度为 88.33%。此外，70.41%的护士使用 CAPA 全面记录。