住院患者中重度疼痛护理质量改进策略及效果  

Strategies and effectiveness on improving quality of nursing care for inpatients with moderate to severe pain

作　　者：王秀丽 何苗[1] 张妍 王茜[1] 张海燕[2] WANG Xiuli;HE Miao;ZHANG Yan;WANG Xi;ZHANG Haiyan(Department of Anesthesiology,Peking University People's Hospital,Beijing,100044,China)

机构地区：[1]北京大学人民医院麻醉科,北京市100044 [2]北京大学人民医院护理部,北京市100044

出　　处：《中国护理管理》2023年第10期1467-1471,共5页Chinese Nursing Management

摘　　要：目的:制定并实施住院患者中重度疼痛管理护理质量改进策略,为临床提高疼痛管理效果提供借鉴。方法:运用文献回顾及问卷调查方法分析住院患者中重度疼痛护理管理中存在的主要问题,制定质量改进策略,包括构建使用阿片类药物后护士疼痛评估完成率指标、完善并更新住院患者疼痛评估规范、构建疼痛护理培训大纲、制作疼痛评估标尺及宣教视频,在全院住院患者中实施。比较质量改进策略实施前、后患者疼痛管理满意度等指标。结果:实施质量改进项目后,护士疼痛评估完成率、疼痛评估准确率、患者疼痛评估总熟知率和患者总满意率均高于改进前(P<0.05)。结论:构建疼痛专科护理敏感质量指标、更新住院患者疼痛评估规范、以护士需求及指南为依据进行疼痛培训等质量改进措施可提高中重度疼痛患者的护理满意度,改善护理质量,有一定临床推广价值。Objective:To develop and implement nursing quality improvement strategies for moderate to severe pain inpatients,providing reference for clinical improvement of pain management.Methods:The issues on management of inpatients with moderate to severe pain was analyzed by literature review and questionnaire survey methods,a quality improvement program on pain management was developed and implemented in all wards,including establishing indicator for pain assessment completion rate among nurses after using opioid drugs,updating pain assessment standards,constructing pain care training outline,developing pain assessment scales and education video.Completion rate and accuracy of pain assessment,familiarity rate,and satisfaction with pain management of inpatients before and after the program were compared.Results:Completion rates,accuracy rates of pain assessment of nurses,total familiarity rates of pain assessment of inpatients,and satisfaction rates of patients with moderate to severe pain were improvement after the implementation of the quality improvement program(P<0.05).Conclusion:The construction of sensitive quality indicators for pain specialized nursing,updating of the inpatient pain assessment standards,and pain training based on nurse needs and guidelines can significantly improve the nursing satisfaction and quality of patients with moderate to severe pain,and is worthy of further clinical application.

关 键 词：疼痛护理 住院患者 满意度 质量改进 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学] R441.1