摘要
目的分析医院癌痛规范化管理现状,评估开展专项质量改善活动对住院患者癌痛管理质量的影响。方法以项目管理理论为依据,以《美国国立综合癌症网络(NCCN)成人癌痛临床实践指南(2019.1版)》《癌症疼痛诊疗规范(2018年版)》《癌痛患者护理指引(专家共识)》等为循证实践管理标准,完善医院癌痛管理规范、癌痛护理管理敏感质量指标。成立癌痛专项质量改进小组,加强全院各临床科室癌痛培训与过程质量督查等管理。结果与改进前比较,改进后健康教育掌握率(91.12%vs.75.69%)、治疗有效率(90.53%vs.80.55%)、疼痛满意率(92.59%vs.75.93%)均升高,漏服药率降低(6.51%vs.13.89%),差异均有统计学意义(P<0.05)。与2018年相比,2019年中度及以上疼痛患者全院会诊率(6.09%vs.2.92%)及疼痛治疗有效率(93.55%vs.86.71%)均升高,差异有统计学意义(P<0.001)。结论通过实施癌痛质量改进项目管理可有效提升医院癌痛管理质量。
Objective To analyze the current situation of standardized management for cancer pain in this hospital,and to evaluate the effect of conducting the special quality improvement activities on inpatients cancer pain management quality.Methods Based on the theory of project management,Clinical Practice Guidelines for Adult Cancer Pain(version 2019.1)of the National Comprehensive Cancer Network(NCCN),Cancer Pain Diagnosis and Treatment Standard(version 2018)and Cancer Pain Patient Nursing Guidelines(Expert Consensus)served as the evidence-based practice management standards,the management standard of cancer pain in hospital and the sensitive quality indicators of cancer pain nursing management were improved.The special quality improvement team for cancer pain was established,and the management of cancer pain training and process quality supervision in all clinical departments were strengthened.Results Compared with before improvement,the mastering rate of health education(91.12%vs.75.69%),treatment effective rate(90.53%vs.80.55%)and pain satisfaction rate(92.59%vs.75.93%)after improvement were increased,the missed dose rate(6.51%vs.13.89%)was decreased,and the differences were statistically significant(P<0.05).Compared with 2018,the consultation rate of the whole hospital in patients with moderate pain or above in 2019(6.09%vs.2.92%)and pain treatment effective rate(93.55%vs.86.71%)were increased,and the differences were statistically significant(P<0.001).Conclusion Implementing the cancer pain quality improvement project can effectively increase of the hospital cancer pain management quality.
作者
唐玲
皮远萍
余慧青
邓本敏
张照莉
唐榕英
TANG Ling;PI Yuanping;YU Huiqing;DENG Benmin;ZHANG Zhaoli;TANG Rongying(Affiliated Tumor Hospital of Chongqing University/Chongqing Key Laboratory of Translational Research for Tumor Metastasis and Individualized Treatment,Chongqing 400030,China)
出处
《重庆医学》
CAS
2021年第15期2597-2601,共5页
Chongqing medicine
基金
重庆市科学技术委员会基金资助项目(cstc2018jcyjAX0737、cstc2018jscx-msybx0030)。
关键词
循证实践
癌痛管理
质量改进
evidence-based practice
cancer pain management
quality improvement
