降低骨科病人手術後疼痛程度

Reduce the Degree of Postoperative Pain in Orthopedic Patients

疼痛為骨科病人手術後常見健康問題之一，如疼痛未被妥善處理，恐影響其復健意願，引發專案小組成立動機。於2015年4月15日至4月30日調查30名病人手術後當日疼痛程度數字量表平均為8.13分，調查分析主因為護理師執行疼痛評估完整率及疼痛評估與處置認知率低、骨科病人術後疼痛處置認知率低；解決辦法以製作「彩色疼痛評估隨身捲尺」與「疼痛評估提示卡」，以提醒護理師交班重點、討論及宣導疼痛口訣「PAIN」，並藉專科在職教育訓練，提昇人員疼痛評估與處置完整性；專案結果為骨科病人手術當日疼痛程度數字量表由平均8.13分降至3.80分，護理師執行疼痛評估正確率大幅提升至97.1％，故應正確執行疼痛評估與積極處置，以提高專科照護品質。

Pain is one of the most common health related issues for patients after orthopedic surgery. If the pain can not be managed properly, the patient may not be willing to participate in the rehabilitation program. Therefore, we were motivated to establish this project to improve this situation. From April, 15 to April, 30 2015, we evaluated the postoperative pain scores of 30 patients at the day of surgery. The average pain score was 8.13 points out of 10. This unsatisfactory result came from incompletion of pain assessment by nurses, poor knowledge about pain assessment, and inadequate pain management of nurses and patients. The solutions were conducted during in-service education which included creating a “colored tape measure” for pain assessment, promoting the use of “flash cards” to remind pain assessment for each shift, and establishing discussion and promotion of “PAIN” phrase to shift. As a result, pain scores of patients decreased to 3.80 and the proper rate of pain assessment and management increased up to 97.1%. Our study suggests that accurate and precise execution of pain management would improve the quality of postoperative nursing care.