CANCER PAIN EDUCATION--AN ANLGESIC DOSING SERVICE

需要采用以患者为导向的床旁教学的创新方法 教育医生和医疗保健专业人员在癌症疼痛 管理 我们建议[测试是否]在现有的 西北纪念医院的住院职业单位[将改善 医生知识和患者舒适度]。32名住院患者 西北大学的床肿瘤学单位将接受录取， 疼痛评估每个班次使用视觉模拟量表，由护理， 每日床边图表的一部分。 所有患者均出现疼痛， 有门旁图表显示或有任何止痛订单的人 书面的，随后将进行止痛剂给药服务。服务 将从位于装置上的药房运行， 确定[医生]教师谁有特别的兴趣， 疼痛管理 止痛剂给药服务将负责 评价镇痛剂量、镇痛剂给药途径 处方，适当转换患者的家庭镇痛治疗 到住院治疗（例如，从口服药物转为IV药物） 评价适当的突破性药物和使用共同 止痛药和适当的治疗副作用。 所有患者将 由配量服务部门进行日常评估。 如果 止痛剂给药服务的说明/建议 药剂师/医生团队没有改善疼痛管理， 通过视觉模拟量表评估判断，患者将被视为 疼痛管理系的一名教员[From日常问题导向 指导他们的病人以及角色建模，我们预计， 家政人员将明显提高其疼痛控制技能]。 为了进一步促进改善疼痛管理，在第一次 每四至五周内部工作人员轮换一周，三次研讨会 涵盖等效镇痛剂量表的使用、阿片类药物的使用原则 和治疗副作用和适当使用coanalgics，将 由疼痛管理学院进行。疼痛管理学院将 此外，使自己可用于咨询任何疼痛 管理相关问题。 ”“行，行。 我们希望通过对每个患者的不适当干预来证明 医生能力和患者舒适度的显著变化， 该计划的机构。

Innovative methods utilizing patient oriented bedside teaching are needed to educate physicians and health care professionals in cancer pain management. We propose to [test whether] an analgesic dosing service on an existing inpatient career unit at Northwestern Memorial Hospital [will improve physician knowledge and patient comfort]. All patients admitted to the 32 bed oncology unit of Northwestern University will undergo an admission and pain assessments each shift using a visual analog scale, by nursing, as part of daily bedside charting. All patients noted to have pain as indicated by the doorside charting or who have any analgesic order written, will be followed by the analgesic dosing service. The service will be run from the pharmacy located on the unit in concert with already identified [physician] faculty members who have a particular interest in pain management. The analgesic dosing service will be responsible for evaluating analgesic doses, route of administration of analgesics prescribed, appropriate conversions of patients' home analgesic therapies to in-hospital therapies (e.g., conversion from oral to IV medication) evaluation for appropriate breakthrough medications and use of co- analgesics and appropriate treatment of side effects. All patients will undergo daily evaluation by the dosing service. If instructions/suggestions by the analgesic dosing service pharmacist/physician team do not result in improved pain management as judged by the visual analog scale evaluations, the patient will be seen by one of the pain management faculty members. [From daily problem oriented instruction on their patients as well as role modeling, we anticipate that housestaff will demonstrably improve their skills in pain control]. In order to further promote improved pain management, during the first week of each four to five week housestaff rotation, three seminars covering the use of equianalgesic dosing tables, principle of opioid use and treatment of side effects and appropriate use of coanalgesics, will be conducted by the pain management faculty. The pain management faculty will additionally make themselves available for consultation for any pain management related question. By providing instruction, guidance, and prompt correction [of inappropriate] intervention [s] on every patient, we hope to demonstrate significant changes in physician competence and patient comfort after institution of the program.