Department of Nursing, Children's Hospital of Soochow University, Suzhou, China.
Department of Nursing, Suzhou Wujiang District Children's Hospital, Suzhou, China.
Nurs Open. 2023 May;10(5):3042-3051. doi: 10.1002/nop2.1551. Epub 2022 Dec 25.
Postoperative pain has adverse effects on children with urological problems, including sleep disturbances, incision dehiscence, bleeding and delayed recovery. Accurate parental assessment of children's behaviours and responses could help to manage postoperative pain. We aimed to implement evidence-based practice for parental involvement in a urology ward, to increase parents' participation in children's postoperative pain management.
The project was conducted in a paediatric urology ward using the framework and methods of the Fudan University Evidence-Based Nursing Center's Evidence-based Continuous Quality Improvement Model.
Fifteen audit criteria were used to represent best practice recommendations for parental involvement in postoperative pain management. A pre-implementation audit was conducted with 211 randomly sampled children and parents. Obstacles, promoting factors and key strategies were analysed, and evidence-based interventions implemented to improve compliance. A follow-up audit using the same audit criteria was conducted with 202 children and parents to assess the effect of targeted strategies on compliance with best practice. The SQUIRE guidelines were followed.
At the baseline audit, compliance with the evidence-based criteria was 0%-71.5%; only five audit criteria achieved a compliance rate > 60%. After best practice implementation, the follow-up audit showed compliance improvements for all criteria; compliance for three criteria improved to 100%.
This best practice implementation project improved parents' participation in children's postoperative pain management. The findings demonstrate how audits can promote best practice in postoperative pain management for children. Additional studies will be conducted to address children's postoperative life quality based on best practice.
泌尿外科患儿术后疼痛会产生诸多不良影响,包括睡眠紊乱、切口裂开、出血和恢复延迟等。准确评估患儿行为和反应有助于管理术后疼痛。本研究旨在实施基于证据的实践,以增加父母参与泌尿外科患儿术后疼痛管理。
本项目在儿科泌尿科病房进行,使用复旦大学循证护理中心循证持续质量改进模型的框架和方法。
15 项审核标准用于代表父母参与术后疼痛管理的最佳实践建议。对 211 名随机抽样的患儿及其父母进行了预实施审核。分析了障碍、促进因素和关键策略,并实施了循证干预措施以提高依从性。使用相同的审核标准对 202 名患儿及其父母进行了后续审核,以评估针对特定策略对最佳实践依从性的影响。
基线审核时,证据审核标准的依从率为 0%-71.5%;仅 5 项审核标准的依从率>60%。实施最佳实践后,所有标准的后续审核均显示依从性提高;3 项标准的依从性提高到 100%。
本最佳实践实施项目提高了父母对患儿术后疼痛管理的参与度。研究结果表明,审核如何促进儿童术后疼痛管理的最佳实践。将进一步开展研究,以最佳实践为基础,探讨儿童术后生活质量。