Ferrell B R, Dean G E, Grant M, Coluzzi P
Department of Nursing Research and Education, City of Hope National Medical Center, Duarte, CA 91010, USA.
J Clin Oncol. 1995 Sep;13(9):2158-65. doi: 10.1200/JCO.1995.13.9.2158.
To share the development, implementation, and evaluation of a program called "An Institutional Commitment to Pain Management," which is based on the philosophy of organizational influence on pain management.
A tested pain education model was disseminated to 32 physician/nurse teams in settings throughout California, after which the 64 professionals returned to their institutions to serve as role models and catalysts to change the practice of pain management. Each team member completed a 39-item survey about knowledge and attitudes related to pain, which was developed by B.R.F. and colleagues, and also identified three goals for the implementation of course information. Precourse data also included administration of the knowledge and attitudes survey to participating physicians' and nurses' colleagues (10 physicians and 20 nurses per institution). Each team completed five chart audits using the pain audit tool (PAT), which was developed by B.R.F. and colleagues at the City of Hope National Medical Center. The PAT identifies how pain is managed currently at the institutional level. Final course evaluation 8 months after course completion included a summary of activities implemented by the teams as well as the factors that served as barriers and benefits to improve the quality of pain management.
Two hundred seventy-two physicians and 629 nurses completed the survey about knowledge and attitudes related to pain, and 154 PATs were submitted. These results, as well as evaluation at the completion of the course, are discussed.
The Institutional Commitment to Pain Management program is an evolving model that was developed to overcome barriers to pain relief by obtaining the commitment from institutions to improve the management of pain for their patients.
分享一个名为“对疼痛管理的机构承诺”项目的开发、实施和评估情况，该项目基于组织对疼痛管理产生影响的理念。
一个经过测试的疼痛教育模式被传播给加利福尼亚州各地医疗机构的32个医生/护士团队，之后这64名专业人员回到各自机构，成为改变疼痛管理实践的榜样和推动者。每个团队成员完成了一份由B.R.F.及其同事编制的、包含39个项目的关于疼痛相关知识和态度的调查问卷，并确定了实施课程信息的三个目标。课前数据还包括对参与项目的医生和护士的同事（每个机构10名医生和20名护士）进行知识和态度调查。每个团队使用由希望之城国家医疗中心的B.R.F.及其同事开发的疼痛审核工具（PAT）完成了五次病历审核。PAT用于确定机构层面目前对疼痛的管理方式。课程结束8个月后的最终课程评估包括各团队实施活动的总结以及对提高疼痛管理质量起到阻碍或促进作用的因素。
272名医生和629名护士完成了关于疼痛相关知识和态度的调查，共提交了154份PAT。讨论了这些结果以及课程结束时的评估情况。
“对疼痛管理的机构承诺”项目是一个不断发展的模式，旨在通过促使机构承诺改善对患者疼痛的管理来克服疼痛缓解方面的障碍。
