Improving pain management in critical care.
Jt Comm J Qual Improv
; 22(10): 702-12, 1996 Oct.
Article
em En
| MEDLINE
| ID: mdl-8923169
ABSTRACT
BACKGROUND:
In April 1994 at the University of California at Los Angeles Medical Center the Surgical Intensive Care Unit's (SICU's) Quality Improvement Council unanimously agreed on pain management as one of the major factors that negatively affect outcomes for their patient population. Using the FOCUS-PDCA (plan-do-check-act) model for quality improvement (QI), the council chartered a subcommittee to improve the pain management in their ICUs.METHODOLOGY:
The subcommittee first measured the pain assessment scores of patients at transfer from the ICU. After ascertaining that these scores were greater than the goal of 2, the process of providing pain relief was examined with the assistance of process control statistics, which showed a process barely capable of meeting the goal of pain score of 2 or less on a 0-5 scale. The process factors that affected this outcome were examined and changes were made where appropriate. One of these changes was development of a guideline for acute pain management based on the Agency for Health Care Policy Research's Acute Pain Management Clinical Practice Guideline. Reassessment of the pain scores and the process was then conducted.RESULTS:
The pain assessment scores at transfer from the ICU decreased significantly. Thirty-five percent of patients in the preguideline survey rated their scores as greater than 2, compared with only 21% at the postguideline survey. Pain assessment and documentation also improved significantly.CONCLUSION:
The Quality Improvement Council felt that improvements in pain management were due largely to their having provided staff with the right tools to use in assessing, documenting, and controlling pain. Gains in pain management continue to be made.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dor
/
Guias de Prática Clínica como Assunto
/
Gestão da Qualidade Total
/
Unidades de Terapia Intensiva
Tipo de estudo:
Guideline
/
Prognostic_studies
/
Qualitative_research
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Jt Comm J Qual Improv
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
/
SERVICOS DE SAUDE
Ano de publicação:
1996
Tipo de documento:
Article
País de afiliação:
Estados Unidos