Enhancing Pain Assessment in Pediatric Sickle Cell Disease by Applying Quality Improvement Science.
Enhancing Pain Assessment in Pediatric Sickle Cell Disease by Applying Quality Improvement Science.
复制标题
应用质量改进科学加强小儿镰状细胞病的疼痛评估。
DOI：
10.1037/cpp0000277
复制
发表时间：
2019
影响因子：
1.1
通讯作者：
New,Tamara
中科院分区：
文献类型：
--
作者：
Sil,Soumitri;Goldstein-Leever,Alana;Travers,Curtis;Gilleland-Marchak,Jordan;Alexander,Ashley;Thompson,Beth;Griffin,Anya;McCracken,Courtney;New,Tamara
目的：对因疼痛住院的青少年进行标准化的疼痛评估和干预。这一质量改进项目整合到儿科心理服务，旨在增加疼痛相关的功能能力的标准化评估的青少年镰状细胞病（SCD）住院pain.Method：儿童和青少年（n = 102）与SCD提到的心理咨询不良应对疼痛住院期间完成了一个有效的自我报告的功能能力，除了疼痛强度在住院期间的心理访视。在质量倡议时，疼痛相关功能能力的常规和标准化评估未纳入标准临床护理。计划-做-研究-行动周期确定了可行性，并解决了在住院心理访视期间对SCD青少年疼痛相关功能能力进行常规评估和记录的常见障碍，其主要目标是在1年内将接受儿科心理咨询以解决疼痛管理的SCD患者的功能能力评估提高到至少85%。通过反复的计划-执行-学习-行动循环，在心理学访问期间对疼痛相关功能能力的常规评估在12个月的过程中平均增加到93%。常规，标准化的功能能力评估被认为是可行的儿科psychologyservice.Conclusions/Lessons：该项目支持的可行性整合的功能能力，以提高疼痛评估的青年SCD疼痛住院作为常规临床护理的一部分，在一个多学科的设置，无论心理referreration.Implications的影响StatementThis项目说明，小系统的变化，使用迭代的质量改进过程可以提高疼痛相关的功能能力的评估率为青年镰状细胞病住院疼痛。改进的多维疼痛评估对于临床医生实施和患者完成是可行的。
Objective:Standardized pain assessment and interventions are recommended for youth hospitalized for pain. This quality improvement project integrated into a pediatric psychology service aimed to increase the standardized assessment of pain-related functional ability for youth with sickle cell disease (SCD) hospitalized for pain.Method:Children and adolescents (n= 102) with SCD referred for psychology consultation for poor coping in response to pain during hospitalization completed a validated self-report of functional ability in addition to pain intensity during inpatient psychology visits. At the time of the quality initiative, routine and standardized assessment of pain-related functional ability was not integrated into standard clinical care. Plan–do–study–act cycles determined the feasibility and addressed common barriers of routine assessment and documentation of pain-related functional ability among youth with SCD during inpatient psychology visits with the primary goal to increase assessment of functional ability to at least 85% among patients with SCD referred for pediatric psychology consultation to address pain management within 1 year.Results:Through iterative plan–do–study–act cycles, routine assessment of pain-related functional ability during psychology visits increased to an average of 93% over the course of 12 months. Routine, standardized assessment of functional ability was considered feasible within a pediatric psychology service.Conclusions/Lessons Learned:This project supported the feasibility of integrating standardized assessment of functional ability to enhance pain assessment for youth hospitalized for SCD pain as part of routine clinical care in a multidisciplinary setting regardless of psychology referral.Implications for Impact StatementThis project illustrates that small systematic changes using an iterative quality improvement process can improve the assessment rates of pain-related functional ability for youth with sickle cell disease hospitalized for pain. Improved multidimensional pain assessment was feasible for clinicians to implement and for patients to complete.