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Documentation of Pain Management with TT- 2000+ in May 2008 Viewed from Clinical Nursing Practice

机译：2008年5月与TT-2000+疼痛管理的文件从临床护理实践中观看

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Background: Electronic Patient Record (EPR) TT- 2000+ was implemented in Hospital Orton in January 2008. The software TT 2000+ was implemented in 2005. TT- 2000+ enables structured and specifically defined documentation in clinical nursing practice. Objectives: To describe the use of pain management documentation into TT- 2000+ and how the results can be implemented into clinical nursing practice. Can the results be used in development of clinical nursing practice? How does the evaluation of pain reflect into the number of documentation? Methods: The data were obtained from documentations made in May 2008 from patient groups that had undergone total hip arthroplasty and total knee arthroplasty. Results: The number of total hip arthroplasty patients was 60 and total knee arthroplasty patients 51. The total number of pain documentations with the group of THA's was 992 and with TKA's 913. Discussion: Due to the circumstances in May 2008, the numbers of documentation into the TT- 2000+ are inadequate. Therefore, the documentation needs farther research within a longer period of time. Undefined and unified way of maintaining and recording should be considered in processing information in clinical practice.
机译：背景：电子患者记录（EPR）TT-2000+于2008年1月在奥顿奥顿实施。该软件TT 2000+于2005年实施。TT-2000+在临床护理实践中实现了结构化和明确的文件。目标：将疼痛管理文档的使用与TT-2000 +的使用以及如何实施临床护理实践。结果可以用于临床护理实践的发展吗？疼痛的评估如何反映在文件数量中？方法：数据是从2008年5月在经历过全髋关节置换术和全膝关节成形术的患者组中获得的文件。结果：总髋关节置换术患者的数量为60岁，膝关节间关节置换术患者51.患者的总疼痛文件总数为992，TKA的913.讨论：由于2008年5月的情况，文件数量进入TT-2000+不足。因此，文档需要在更长的时间内进行更远的研究。在临床实践中的处理信息中，应考虑未定义和统一的维护和记录方式。

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