ACUTE PAIN MANAGEMENT TO IMPROVE PATIENT OUTCOMES

这项拟议研究的目的是评估一项 疼痛管理教育计划，专为护士、医生和 为病人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 社区医院中无疼痛患者疼痛管理的效果 管理服务。 一个由疼痛管理专家组成的多学科团队将前往6个国家 社区医院将推出为期3节的教育计划 否则就没有机会参与的参与者 在这样的一个项目中。该程序将用Delphi开发 过程，将促进患者结局的改变，这既是 生理和心理上的。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，以及以医院为基础的项目的持续发展 质量提升。该计划的独特之处在于它强调 评估可能调节对疼痛反应的生物行为因素； 它还使用了AHCPR指南中关于急性疼痛的建议 管理层。对照受试者将在课程结束时接受培训 数据收集期。 该计划的有效性将使用2×3设计进行衡量 治疗水平(干预与对照)是第一个因素， 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 独立，并形成主体间的因素。总样本量为 由大约126名卫生保健提供者和900名患者组成。 测量将包括对疼痛活动证据的图表审计 管理和患者访谈，了解疼痛强度、对 活动和救济。多元模型将被用来检验 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.