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The quality of postoperative pain management from the perspectives of patients, nurses and patient records

机译：从患者，护士和患者记录的角度看术后疼痛管理的质量

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Aim To study the quality of postoperative pain management in a university hospital. Method Paired patient and nurse assessments of the patient's pain management were conducted in two departments, complemented with audit of patient records. The Strategic and Clinical Quality Indicators in Postoperative Pain Management questionnaire was answered by 121 patients and 47 Registered Nurses. Results Of 14 items in the Strategic and Clinical Quality Indicators in Postoperative Pain Management questionnaire, four items in general surgery and five items in thoracic surgery reached the threshold for high quality of care. No significant differences were found between the assessments in the two departments, but the patients in general surgery experienced more pain than the patients in thoracic surgery. In general surgery, the patients assessed their worst pain significantly higher than the nurse did. The patients who experienced more pain than expected were less satisfied with the quality of their care and experienced higher pain intensity levels. For 25 (41.0%) patients in general surgery and four (6.7%) patients in thoracic surgery, pain intensity was documented according to hospital quality goals. Conclusion In both departments, areas for improvements could be found in all subscales of the Strategic and Clinical Quality Indicators in Postoperative Pain Management questionnaire, i.e. communication, action, trust and environment. It is important to discuss what information the patient needs, as well as how and when it should be given. Furthermore, considering earlier pain experience and the goal of pain relief for the individual patient may facilitate an adequate assessment of the patient's pain. In future, electronic health records have the potential to support the use of clinical guidelines.
机译：目的研究某大学医院术后疼痛处理的质量。方法在两个部门对患者和护士进行疼痛管理的配对评估，并辅以对患者记录的审核。术后疼痛管理策略和临床质量指标问卷由121位患者和47位注册护士回答。术后疼痛管理策略和临床质量指标中的14项结果，普通外科手术中的4项和胸外科手术中的5项达到了高质量护理的门槛。在两个科室之间的评估之间没有发现显着差异，但是普通外科手术患者比胸外科手术患者经历的疼痛更大。在普通外科手术中，患者评估出的最严重疼痛程度明显高于护士。疼痛多于预期的患者对其护理质量不满意，并且疼痛强度较高。对于25例（41.0％）的普通外科手术患者和4例（6.7％）的胸外科患者，根据医院质量目标记录了疼痛强度。结论在两个部门中，术后疼痛管理问卷中战略和临床质量指标的所有子量表（即沟通，行动，信任和环境）都可以发现需要改进的地方。重要的是讨论患者需要什么信息，以及应该如何以及何时给出。此外，考虑较早的疼痛经历和针对单个患者的缓解疼痛的目标可以促进对患者疼痛的充分评估。将来，电子健康记录有可能支持临床指南的使用。

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