運用多元策略提升護理人員執行疼痛評估正確率之專案

Use of Multiple Strategies for Implementation of the Project to Assessment the Accuracy of Pain

提升疼痛評估能力是疼痛處理品質重要的一環。疼痛處置過程首重準確的疼痛評估，透過疼痛評估結果並詳細的記錄，才能適當處置且正確用藥，有效降低疼痛程度以對生活的影響。本專案旨在提升護理人員執行疼痛評估正確率。臨床發現護理人員疼痛評估內容不完整、工具使用錯誤、缺乏實作教學及評估指引、執行疼痛評估認知不足等，影響護理人員執行疼痛評估正確率僅57.6%，經專案措施介入：1. 建置疼痛評估照護指引。2. 舉辦疼痛評估教育訓練。3. 發展疼痛評估mini-CEX 評量表。4. 設計疼痛評估輔助工具。專案實施後，護理人員疼痛評估認知率提升31.7%、執行疼痛評估正確率由改善前57.1% 提升至91.3%，病人滿意得分也由3.5 分提升至4.2分(5 分法) 達專案目的。期能提供教育界規劃完整疼痛評估與照護課程，並做為新進人員訓練基礎，有效運用於臨床實務，共同改善病人疼痛問題，達病人、護師及醫院三贏局面。

The enhancement of nurses’ pain assessment capabilities is an important part of the quality of pain management. Through pain assessment results and detailed records, appropriate disposal and medication can be administered, thereby effectively reducing the degree of pain and decreasing its impact on life. The project aims to enhance the accuracy of nurses to perform pain assessment. Several problems were identified including incomplete pain assessment performed by nurses, wrong tools were used, lack of clear guidance for teaching and assessment, and inadequate recognition of implementing pain assessment. As a result, only 57.6% of nurses performed proper pain assessment. The project intervention measures included: 1. building a care guide for pain assessment; 2. organizing pain assessment education and training courses; 3. developing pain assessment mini-CEX assessment sheet; 4. designing pain assessment aid tools. After implementing the project, the perception of pain assessment among nurses increased 31.7%, the execution of pain assessment increased from 57.6% to 91.3%, and the patients’ satisfaction score increased from 3.5 to 4.2 out of 5. The article provides a reference for designing a training program to enhance the ability to perform pain assessment among nurses so that the quality of pain care can be improved.