Xiao Ting, Wang Yangyang, Zhou Chun, Yan Peiting
Department of Orthopedics, Xiangtan Central Hospital, Xiangtan, Hunan, China.
Br J Hosp Med (Lond). 2024 Nov 30;85(11):1-14. doi: 10.12968/hmed.2024.0450. Epub 2024 Nov 18.
A multidisciplinary team (MDT) approach is a nurse-led pain management method that involves collaboration with staff from other departments. The purpose of this paper was to discuss the construction and application effect of a pain care ward in orthopedics utilizing the MDT approach. A retrospective analysis of case data was conducted, selecting 90 patients with hip joint fractures who underwent hip replacement arthroplasty (HRA) at our hospital between February 2021 and February 2024. The patients were divided into two groups based on the nursing methods: a control group (n = 43), which received a conventional analgesic management program, and an intervention group (n = 47), which received the same conventional analgesic management program along with the implementation of an orthopedic pain care ward under the MDT approach. The study compared the pain knowledge and attitudes of the responsible nurses in both groups through questionnaires. Additionally, the accuracy of pain assessments and the awareness rates of patients' pain-related health education were evaluated and compared between the two groups. Furthermore, the effectiveness of pain intervention, range of motion (ROM), and Hospital for Special Surgery (HSS) scores before and after the intervention were analyzed. The incidence of complications and overall nursing satisfaction were also compared between the two groups. The general knowledge, pain assessment, drug analgesia, comprehensive application, and total scores of nurses in the intervention group were significantly higher than those in the control group ( < 0.05). The accuracy rate of nurses' pain assessments and the awareness rate of patients' pain health education in the intervention group were 91.49% and 93.62%, respectively, both significantly higher than the 72.09% and 79.07% observed in the control group ( < 0.05). The total effective rate of pain intervention in the intervention group was 74.47%, significantly higher than the 53.49% in the control group ( < 0.05). After the intervention, both the ROM and HSS scores in the intervention group were significantly higher than those in the control group ( < 0.05). The overall incidence of complications in the intervention group was 6.38%, significantly lower than the 20.93% in the control group ( < 0.05). Finally, the total satisfaction rate with nursing care in the intervention group was 91.49%, significantly higher than the 74.42% in the control group ( < 0.05). The construction and application of an MDT pain care ward can effectively enhance the accuracy of nurses' pain assessments, increase patients' awareness of pain-related health education, and improve the efficiency of pain interventions. Additionally, it can lead to better joint mobility and improved hip function, promoting the sustainable development of the pain care ward. These improvements contribute to higher patient satisfaction and enrich the quality of nursing services.
多学科团队(MDT)方法是一种由护士主导的疼痛管理方法,涉及与其他部门的工作人员合作。本文旨在探讨采用MDT方法构建骨科疼痛护理病房及其应用效果。对病例数据进行回顾性分析,选取2021年2月至2024年2月在我院接受髋关节置换术(HRA)的90例髋关节骨折患者。根据护理方法将患者分为两组:对照组(n = 43),接受常规镇痛管理方案;干预组(n = 47),在接受相同常规镇痛管理方案的同时,采用MDT方法实施骨科疼痛护理病房。通过问卷调查比较两组责任护士的疼痛知识和态度。此外,评估并比较两组疼痛评估的准确性和患者疼痛相关健康教育知晓率。进一步分析干预前后疼痛干预的效果、关节活动度(ROM)和特殊外科医院(HSS)评分。比较两组并发症发生率和总体护理满意度。干预组护士的一般知识、疼痛评估、药物镇痛、综合应用及总分均显著高于对照组(P < 0.05)。干预组护士疼痛评估准确率和患者疼痛健康教育知晓率分别为91.49%和93.62%,均显著高于对照组的72.09%和79.07%(P < 0.05)。干预组疼痛干预总有效率为74.47%,显著高于对照组的53.49%(P < 0.05)。干预后,干预组的ROM和HSS评分均显著高于对照组(P < 0.05)。干预组并发症总发生率为6.38%,显著低于对照组的20.93%(P < 0.05)。最后,干预组护理总满意度为91.49%,显著高于对照组的74.42%(P < 0.05)。MDT疼痛护理病房的构建与应用可有效提高护士疼痛评估的准确性,提高患者对疼痛相关健康教育的知晓率,提高疼痛干预效率。此外,还可改善关节活动度,提升髋关节功能,促进疼痛护理病房的可持续发展。这些改善有助于提高患者满意度,丰富护理服务质量。