北京市67家医院癌痛管理相关护理质量水平分析  

Analysis of the quality of nursing care for cancer pain management in 67 hospitals from Beijing

作　　者：许丽媛[1] 魏梦娅 覃旺军[2] 杨阳[1] 杨青[1] 樊碧发[1] XU Liyuan;WEI Mengya;QIN Wangjun;YANG Yang;YANG Qing;FAN Bifa(Department of Pain Management,China Japan Friendship Hospital,Beijing 100029,China;Pharmaceutical Department,China Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院疼痛科,北京100029 [2]中日友好医院药学部,北京100029

出　　处：《中国疼痛医学杂志》2021年第5期362-366,共5页Chinese Journal of Pain Medicine

基　　金：国家临床重点专科建设项目(2014-zdzk-002)。

摘　　要：目的:调查北京市癌痛管理现状,为更好地落实疼痛管理工作和规范癌痛管理提供参考依据。方法:以2019年7月至2019年9月参与北京市癌痛规范化治疗示范病房现场评审的67家医院为研究对象,依据北京市癌痛规范化示范病房现场评审标准,对疼痛评估、住院疼痛病人宣教及居家疼痛病人随访进行调查分析。结果:北京市共有67家医院参与此次检查,其中三级甲等医院30家(44.7%)、三级乙等医院18家(26.8%)、二级及以下医院19家(28.3%)。所有受检医院的护理质量部分均能达到检查要求,合格率为100%,其中评分为“优秀”的有40家(59.7%)、“合格”的有27家(40.3%)。在疼痛常规评估、体温单记录疼痛、动态评估疼痛、重度疼痛交班记录、疼痛宣教、疼痛随访这6个分项目中,平均得分最高的是“重度疼痛交班记录”项目,为(4.7±0.6)分;平均得分最低的是“疼痛常规全面评估”项目,为(4.1±0.8)分。三甲医院(27.2±2.5)分和三乙医院(27.5±1.9)分的护理质量总分显著优于二级及以下医院(25.5±2.4)分(P<0.05)。护理质量总分为“优秀”的医院在“动态评估疼痛”、“重度疼痛交班记录”和“疼痛随访”这3个分项目的得分显著高于“合格”医院(P<0.01或P<0.05)。结论:北京地区医疗机构的癌痛护理质量总体合格,但在动态评估疼痛、重度疼痛交班记录和疼痛随访方面仍存在提升空间。因此加强对护士的疼痛管理培训和疼痛随访系统的信息化建设有助于提高癌痛护理服务的整体质量。Objective:To evaluate the current status of cancer pain management in Beijing,and to provide a reference for better implementation of pain management and standard cancer pain management.Methods:Inspection results of standardized diagnosis and treatment for cancer pain were analyzed retrospectively in Beijing pain therapy quality control and improvement center during July to September,2019.According to the on-site evaluation standards of the"Good Pain Management Ward"for cancer pain in Beijing,the qualities of pain assessment,education of hospitalized pain patients and follow-up of home pain patients were investigated and analyzed.Results:A total of 67 hospitals in Beijing participated in the inspection,including 30 tertiary A hospital(44.7%),18 tertiary B hospitals(26.8%),19 secondary hospitals or first-level hospitals(28.3%).Nursing care quality of all hospitals met the inspection requirements with a qualified rate of 100%.Fourty hospitals performed excellently(59.7%),and 27 hospitals were qualified for nursing care quality(40.3%).Among 6 sub-items(routine comprehensive pain assessment temperature sheet to record pain,dynamic assessment of pain,severe pain handover record,pain education,and pain follow-up),the average score of severe pain handover record item was the highest(4.7±0.6);the lowest was the routine comprehensive pain assessment item(4.1±0.8).The results of nursing care quality inspection in tertiary A hospitals(27.2±2.5)and tertiary B hospitals(27.5±1.9)were significantly better than those in secondary hospitals or first-level hospitals(25.5±2.4)(P<0.05).Scores of the hospitals with excellent nursing care quality were significantly higher than those of the hospitals with qualified nursing care quality in terms of dynamic assessment of pain,severe pain handover record and pain follow-up(P<0.01 or P<0.05).Conclusion:The quality of nursing care for cancer pain in medical institutions from Beijing area has reached the qualified level,but the dynamic assessment of pain,severe pain handover record and

关 键 词：护理质量 癌症疼痛 疼痛评估 疼痛随访 

分 类 号：R473[医药卫生—护理学]