ACUTE PAIN MANAGEMENT TO IMPROVE PATIENT OUTCOMES

这项研究的目的是评估 疼痛管理教育计划，专为护士，医生和 为患者提供围手术期护理的药剂师。该计划是 旨在更改围手术期图表-文档和患者报告 社区医院疼痛管理的结果， 管理服务。 一个多学科的疼痛管理专家小组将前往6 社区医院将举办3次教育课程， 否则将没有机会参加的与会者 在这样的节目中。该程序是用德尔菲开发的 过程，将促进患者结果的变化， 生理和心理的。它将解决体制障碍 实践改变，患者评估，药理学和非药理学 管理，并制定以医院为基础的持续计划， 质量改进。该计划的独特之处在于它强调 评估可能调节疼痛反应的生物行为因素; 它还使用了AHCPR急性疼痛指南中的建议 管理对照组受试者将在课程结束时接受该课程。 数据收集期。 该计划的有效性将使用2X 3设计来衡量 治疗水平（干预与对照）为第一因素， 评估样本（干预前、干预后和随访） 第二个因素。不同时间的评估样本为 相互独立，形成主体间因素。总样本将 由大约126名卫生保健提供者和900名患者组成。 测量将包括疼痛活动证据的图表审核 管理和患者访谈的疼痛强度，干扰 活动和救济。多变量模型将用于检验 干预效果。

The aim of the proposed research is to evaluate the effectiveness of a pain management educational program, designed for nurses, physicians and pharmacists who provide perioperative care to patients. The program is designed to change perioperative chart-documentation and patient reported outcomes of pain management in community hospitals who do not have a pain management service. A multidisciplinary team of experts in pain management will travel to 6 community hospitals to present a 3-session educational program for participants who otherwise would not have the opportunity to participate in such a program. The program, which will be developed with a delphi process, will promote change in patient outcomes that are both physiological and psychological. It will address institutional obstacles to practice change, patient assessment, pharmacologic and nonpharmacologic management, and the development of hospital-based programs of continuous quality improvement. The program is unique in its emphasis on the assessment of biobehavioral factors that may modulate responses to pain; its also uses recommendations found in the AHCPR guidelines for acute pain management. Control subjects will be offered the program at the end of the data collection period. The effectiveness of the program will be measured using a 2 X 3 design with treatment levels (intervention vs control) the first factor and the assessment samples (pre-intervention, post-intervention, and follow-up) the second factor. The assessment samples at different times are independent and form a between-subjects factor. The total sample will consist of approximately 126 health care providers and 900 patients. Measurement will include a chart audit for evidence of activities in pain management and patient interviews for pain intensity, interference with activities, and relief. Multivariate models will be used to test for intervention effects.