Epidemiology and management of painful procedures in children in Canadian hospitals
Epidemiology and management of painful procedures in children in Canadian hospitals
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DOI：
10.1503/cmaj.101341
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发表时间：
2011-04-19
影响因子：
14.6
通讯作者：
Finley, G. Allen
中科院分区：
文献类型：
--
作者：
Stevens, Bonnie J.;Abbott, Laura K.;Finley, G. Allen
背景：在医院接受护理的儿童每天都要经历多次痛苦的手术。然而，很少有人知道这些程序的频率和相关的干预措施，以管理疼痛。我们进行了这项研究，以确定，为儿童在加拿大医院，痛苦的程序的频率，类型的疼痛管理干预与痛苦的程序和影响的类型的医院单位对程序疼痛管理。方法：我们回顾了1999年10月至1999年10月期间，加拿大8家儿科医院32个住院部收治的18岁以下婴儿和儿童的病历。2007年和2008年4月。我们记录了在数据收集前24小时内进行的所有疼痛手术和疼痛管理干预措施。我们进行了描述性和比较性（方差分析，卡方检验）analysis.Results：3822名儿童纳入研究，2987（78.2%）经历了至少一个痛苦的程序在24小时内数据收集之前，总共有18929痛苦的程序（平均6.3每个孩子谁有任何痛苦的程序）。对于2334（78.1%）的2987名儿童谁有一个痛苦的程序，疼痛管理干预在过去24小时内记录在图表：1980（84.8%）进行了药物干预，心理干预584例（25.0%），综合干预753例（32.3%）。然而，2987名儿童中只有844名（28.3%）接受了一种或多种疼痛管理干预措施，并专门记录了疼痛手术。儿科重症监护病房报告的比例最高的痛苦的程序和镇痛剂administration.Interpretation：对于不到三分之一的痛苦的程序有一个或多个特定的疼痛管理干预的文件。实施疼痛管理变化的策略必须针对医院单位的类型。
Background: Children being cared for in hospital undergo multiple painful procedures daily. However, little is known about the frequency of these procedures and associated interventions to manage the pain. We undertook this study to determine, for children in Canadian hospitals, the frequency of painful procedures, the types of pain management interventions associated with painful procedures and the influence of the type of hospital unit on procedural pain management.Methods: We reviewed medical charts for infants and children up to 18 years of age who had been admitted to 32 inpatient units at eight Canadian pediatric hospitals between October 2007 and April 2008. We recorded all of the painful procedures performed and the pain management interventions that had been implemented in the 24-hour period preceding data collection. We performed descriptive and comparative (analysis of variance, chi(2)) analyses.Results: Of the 3822 children included in the study, 2987 (78.2%) had undergone at least one painful procedure in the 24-hour period preceding data collection, for a total of 18 929 painful procedures (mean 6.3 per child who had any painful procedure). For 2334 (78.1%) of the 2987 children who had a painful procedure, a pain management intervention in the previous 24 hours was documented in the chart: 1980 (84.8%) had a pharmacologic intervention, 609 (26.1%) a physical intervention, 584 (25.0%) a psychologic intervention and 753 (32.3%) a combination of interventions. However, for only 844 (28.3%) of the 2987 children was one or more pain management interventions administered and documented specifically for a painful procedure. Pediatric intensive care units reported the highest proportion of painful procedures and analgesics administered.Interpretation: For less than one-third of painful procedures was there documentation of one or more specific pain management interventions. Strategies for implementing changes in pain management must be tailored to the type of hospital unit.