Kefyalew Merahi, Deyassa Negussie, Gidey Uqubay, Temesgen Maligna, Mehari Maraki
Department of Emergency and Critical Care Medicine, Addis Ababa University College of Health Science, Ethiopia.
Epidemiology, Department of Public Health, Addis Ababa University College of Health Science, Ethiopia.
Afr J Emerg Med. 2024 Sep;14(3):161-166. doi: 10.1016/j.afjem.2024.06.004. Epub 2024 Jun 26.
Pain management is crucial for improving patients' quality of care. Persistent pain has been linked to higher depression, anxiety, and work-related difficulties. This study aimed to enhance the time to pain relief in the emergency department through triage nurse-initiated analgesia. It evaluated the impact of nurse-led analgesia on patient satisfaction compared to standard pain management at Tikur Anbessa Specialized Hospital and Kidus Paulos Specialized Hospital. Additionally, it compared the time to analgesia between the two hospitals and assessed the effect of nurse-led analgesia on reducing the length of stay for patients with pain.
Using a quasi-experimental design, the study included an intervention group and a control group. Data was collected using an open data kit, and after ensuring data completeness, it was exported to SPSS and Excel for analysis. To assess the effectiveness of the intervention, the time to analgesia was compared between the intervention and control groups using an independent samples -test. This statistical test allowed for a comparison of the mean time to analgesia between the two groups.Patient satisfaction scores were also compared between the intervention and control groups using the Mann-Whitney U test. Kaplan-Meier curves were employed to compare the time to analgesia between the intervention and control groups within both settings. A point bi-serial correlation analysis was performed to examine the association between the length of stay and the intervention of nurse-led analgesia in both hospital settings.
The study enrolled 179 participants, with a median age of 34 years (range: 9-80) and 67% female. The most common events leading to pain were medical conditions (21%), followed by trauma/quarrel/war, fall accidents, and underlying diseases (15%, 13%, and 13%, respectively). There was a significant correlation between the degree of pain on arrival and time to analgesia. Additionally, a significant correlation ( < 0.01) was found between time to analgesia and patient satisfaction.
Implementing a nurse-led analgesia protocol in the emergency department is crucial for reducing time to analgesia and improving patient satisfaction. It is recommended to scale up this approach to other healthcare facilities by incorporating it into the nursing practice guidelines of the country.
疼痛管理对于提高患者的护理质量至关重要。持续性疼痛与更高的抑郁、焦虑以及与工作相关的困难有关。本研究旨在通过分诊护士启动的镇痛措施来缩短急诊科的疼痛缓解时间。它评估了在提库尔·安贝萨专科医院和基杜斯·保罗斯专科医院，与标准疼痛管理相比，护士主导的镇痛对患者满意度的影响。此外，它比较了两家医院的镇痛时间，并评估了护士主导的镇痛对缩短疼痛患者住院时间的效果。
采用准实验设计，该研究包括一个干预组和一个对照组。使用开放式数据采集工具收集数据，在确保数据完整性后，将其导出到SPSS和Excel进行分析。为了评估干预的有效性，使用独立样本t检验比较干预组和对照组的镇痛时间。这种统计检验允许比较两组之间镇痛的平均时间。还使用曼-惠特尼U检验比较干预组和对照组之间的患者满意度得分。采用Kaplan-Meier曲线比较两种情况下干预组和对照组的镇痛时间。进行点二列相关分析以检验两家医院住院时间与护士主导的镇痛干预之间的关联。
该研究招募了179名参与者，中位年龄为34岁（范围：9 - 80岁），女性占67%。导致疼痛的最常见事件是医疗状况（21%），其次是创伤/争吵/战争、跌倒事故和基础疾病（分别为15%、13%和13%）。到达时的疼痛程度与镇痛时间之间存在显著相关性。此外，在镇痛时间与患者满意度之间发现了显著相关性（<0.01）。
在急诊科实施护士主导的镇痛方案对于缩短镇痛时间和提高患者满意度至关重要。建议通过将其纳入该国的护理实践指南，将这种方法推广到其他医疗机构。
