目的 构建以疼痛专科护士为主导的镇痛泵全程管理系统,并评价其应用效果。方法 以疼痛专科护士为主导、病区护士为主体,构建集专科护士工作站模块和病区护士工作站模块为一体的智能化镇痛泵全程管理系统。于2021年7月—10月在某三级甲等综合性医院进行系统试运行,比较系统应用前后镇痛泵患者24 h内镇痛不全率、镇痛相关不良反应阳性探测率、患者满意度和护士工作耗时的差异。结果 镇痛泵全程管理系统使用后,当日20：00镇痛不全发生率由12.9%下降至5.9%（χ2=21.749,P<0.001）;次日09：00镇痛不全发生率由20.1%下降至15.1%（χ2=6.759,P=0.009）;次日16：00镇痛不全发生率差异无统计学意义;镇痛相关不良反应阳性探测率上升,其中恶心呕吐探测率由9.2%上升到31.5%（χ2=119.46,P<0.001）,头晕阳性探测率由3.6%上升到8.1%（χ2=13.96,P<0.001）;患者满意度由（4.90±0.40）分提高到（4.96±0.25）分,疼痛专科护士随访前准备和随访后数据录入耗时由（93.85±11.14） min/d下降至<20 min/d,病区护士评估镇痛泵耗时由（29.72±8.80） s/次下降到2 s/次,差异均具有统计学意义（P<0.05）。结论 疼痛专科护士主导的镇痛泵全程管理系统,能有效改善术后疼痛管理的质量和患者满意度,优化疼痛管理的工作流程和工作效率。
Objective To design a whole-process management system of analgesic pumps led by pain specialist nurses,and to evaluate its application effects. Methods We constructed the whole-process management system of intelligent analgesia pumps that integrated specialized nurse workstation modules and ward nurse workstation modules,led by pain specialist nurses,and with ward nurses as the main body. Meanwhile,a system trial was conducted in a tertiary Grade A general hospital from July 2021 to October 2021 to compare the differences of the inadequate analgesia rate within postoperative 24 hours,positive detection rate of adverse reactions related to analgesia,patient satisfaction,and nurse work time before and after the application of the system. Results After the application of whole-process management system of analgesic pumps,the rate of inadequate analgesia at 20：00 on the same day decreased from 12.09% to 5.9%（χ2=21.749,P<0.001),the rate of inadequate analgesia at 9:00 on the second day decreased from 20.1% to 15.1%（χ2=6.759,P=0.009）,the rate of inadequate analgesia at 16：00 on the second day had no statistically difference. The positive detection rate of analgesic related adverse reactions increased,the positive detection rate of nausea and vomiting increased from 9.2% to 31.5%（χ2=119.469,P<0.001) and the positive detection rate of dizziness increased from 3.6% to 8.1%（χ2=13.96,P<0.001). The patient satisfaction also increased from （4.90 ± 0.40） to （4.96 ± 0.25）,the average work time per day of specialized pain nurses decrea-sed from （93.85 ± 11.14） min/d to less than 20 minutes,and the average evaluation time for the analgesic pumps by ward nurses decreased from （29.72±8.80） s/time to 2 s/time,and the differences were statistically significant（P<0.05）. Conclusion Analgesia pump whole-process management system led by pain specialist nurses can not only effectively improve the quality of postoperative pain management and patient satisfaction,but also optimize the workflow and efficiency of pain management.
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