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首页> 外文期刊>The journal of pain: official journal of the American Pain Society >Institutionalizing pain management: the Post-Operative Pain Management Quality Improvement Project.
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Institutionalizing pain management: the Post-Operative Pain Management Quality Improvement Project.

机译：制度化疼痛管理：术后疼痛管理质量改善项目。

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Clinical practice and quality improvement (QI) guidelines for acute postoperative pain management have been developed to address the well-documented problem of undertreatment of postoperative pain. The Post-Operative Pain Management Quality Improvement Project (the POP Project) was initiated to determine whether an intervention designed to support hospitals in the development of QI efforts would lead to improvements in structures, processes, and outcomes consistent with recommended guidelines. A nationwide sample of 233 hospitals joined the project. The intervention consisted of written resource materials accompanied by support services that included an e-mail list server, a resource Web page, and assistance from POP Project staff via telephone. Data regarding critical structures, processes (practice patterns), and patient outcomes were collected at baseline before the intervention began and at follow-up 12 to 18 months later. Results showed a statistically significant increase from baseline (45%) to follow-up (72%) in the presence of structural elements that are critical to improving pain management. There were statistically significant improvements in practices including documented use of pain rating scales, decreased use of intramuscular opioids, and increased use of nonpharmacologic strategies. Patient survey data showed no change in pain outcomes. Evaluation data showed that 70% of hospitals were very or extremely satisfied with their participation in the POP Project and 90% of them planned to continue efforts to improve pain management after the POP Project ended. Further research is needed to determine how to translate the excellent results obtained for structure and process into meaningful outcomes for patients.
机译：已经开发了用于急性术后疼痛管理的临床实践和质量改进（QI）指南，以解决术后疼痛治疗不足的有据可查的问题。启动了术后疼痛管理质量改善项目（POP项目），以确定旨在支持医院开展QI努力的干预措施是否会导致结构，流程和结果的改善，与建议的指南相符。全国233家医院的样本参加了该项目。干预措施包括书面资源材料以及支持服务，其中包括电子邮件列表服务器，资源网页以及POP项目人员通过电话提供的帮助。有关关键结构，过程（实践模式）和患者预后的数据是在开始干预之前的基线以及随后的12至18个月的随访中收集的。结果显示，在对改善疼痛管理至关重要的结构要素存在下，从基线（45％）到随访（72％）的统计学显着增加。在实践上有统计学上的显着改善，包括已记录的使用疼痛等级量表，减少了肌内阿片类药物的使用以及增加了非药物策略的使用。患者调查数据显示疼痛结局无变化。评价数据显示，有70％的医院对POP项目的参与感到非常满意或非常满意，其中90％的医院计划在POP项目结束后继续努力改善疼痛管理。需要进行进一步的研究以确定如何将结构和过程获得的出色结果转化为对患者有意义的结果。

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