AN AUSTRALIAN AUDIT OF ED PAIN MANAGEMENT PATTERNS
AN AUSTRALIAN AUDIT OF ED PAIN MANAGEMENT PATTERNS
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DOI：
10.1016/j.jen.2010.03.007
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发表时间：
2011-05-01
影响因子：
1.7
通讯作者：
Huckson, Sue
中科院分区：
文献类型：
--
作者：
Fry, Margaret;Bennetts, Scott;Huckson, Sue
引言：及时和适当的疼痛管理是艾德绩效的重要质量指标。紧急卫生保健工作者有能力成为积极的领导者，并在减少人类痛苦方面做出创新反应。疼痛管理审计进行，以确定澳大利亚的做法patterns.Methods：进行了12个月的回顾性描述性队列审计。在随机化过程中，针对识别的每项记录完成了病历稽查工具。结果：74家医院同意进行审核，36家（48%）提供了数据。审查的患者记录总数为2，066份。95%（1，966）的患者是由救护车到达的。在记录有分诊疼痛评分的患者（n=547; 56.4%）中，大多数患者出现重度疼痛（n=300; 41.3%）。在记录到疼痛的患者总数（1，966）中，1，473例（74.9%）接受了镇痛剂。644例（32.7%）患者接受阿片类药物治疗。从到达急诊室开始，镇痛剂给药的中位时间为70分钟（IQR 58分钟至92分钟）。25个急诊科（69.4%）制定了疼痛管理政策，使护士能够在无需医疗咨询的情况下启动药物镇痛。讨论：澳大利亚疼痛管理审计强调了当前的实践和进一步研究的潜在领域。虽然审计表明，护士发起的疼痛管理干预措施促进更好的镇痛反应，更大的一致性分诊疼痛评估，代码分配，并记录疼痛评分可能会在某种程度上提高镇痛的及时性。
Introduction: Timely and appropriate pain management is an important quality indicator of ED performance. Emergency health care workers are well positioned to become active leaders and innovatively responsive in reducing human suffering. A pain management audit was conducted to determine Australia practice patterns.Methods: A 12-month retrospective descriptive cohort audit was undertaken. Through the randomization process a medical record audit tool was completed for each record identified. Ethical approval for the study was obtained.Results: Seventy-four hospitals agreed to conduct the audit, 36 (48%) provided data. The total number of patient notes reviewed was 2,066. Ninety-five percent (1,966) of patients arrived by ambulance. Of the patients (n=547; 56.4%) with a documented triage pain score the majority arrived in severe pain (n=300; 41.3%). Of the total number of patients (1,966) documented arriving in pain 1,473 (74.9%) received an analgesic. Six hundred and forty-four (32.7%) patients received an opioid. From time of emergency department arrival, the median time for analgesic administration was 70 minutes (IQR 58 minutes to 92 minutes). Twenty-five emergency departments (69.4%) had pain management policies that enabled nurses to initiate a pharmacological analgesia without medical consultation.Discussion: The Australian pain management audit highlighted current practices and potential areas for further research. While the audit demonstrated that nurse initiated pain management interventions promoted better analgesic response, greater consistency of triage pain assessment, code allocation, and documentation of pain scores may go some way to improving the timeliness of analgesia.