Wakefield B, Johnson J A, Kron-Chalupa J, Paulsen L
Department of Veterans Affairs Medical Center, Iowa City, USA.
Oncol Nurs Forum. 1998 Oct;25(9):1505-13.
PURPOSE/OBJECTIVES: To describe a research utilization project intended to develop, implement, and evaluate a research-based guideline for the use of transdermal fentanyl.
The guideline was based on existing literature, clinical expert knowledge, manufacturer recommendations, and cost considerations. Principles of guideline development and evaluation were based on recommendations from the Agency for Health Care Policy and Research.
A comparison of data from baseline to six months after guideline implementation revealed improvements in all criteria. Most of the improvements were maintained at 18 months postguideline implementation.
The guideline improved the appropriate use of transdermal fentanyl. Ongoing education and monitoring is necessary to maintain change in practice.
The cost-effective use of expensive technology is a concern in the area of health care. Nurses need to promote the appropriate use of pain-management techniques to provide quality care for patients with chronic pain. Guidelines will help nurses to support the use of higher-cost medications in this subpopulation of patients.
目的/目标：描述一个研究应用项目，旨在制定、实施和评估一项基于研究的透皮芬太尼使用指南。
该指南基于现有文献、临床专家知识、制造商建议以及成本考量。指南制定和评估的原则基于医疗保健政策与研究机构的建议。
对指南实施前基线数据与实施后六个月数据的比较显示，所有标准均有改善。大部分改善在指南实施后18个月得以维持。
该指南改善了透皮芬太尼的合理使用。持续的教育和监测对于维持实践中的改变是必要的。
在医疗保健领域，昂贵技术的成本效益使用是一个关注点。护士需要促进疼痛管理技术的合理使用，以便为慢性疼痛患者提供优质护理。指南将帮助护士在这类患者亚群中支持使用成本更高的药物。
