66家医疗机构儿童疼痛管理现状调查

摘要

目的:调查国内医院儿童疼痛管理的实践现状,为制定儿童疼痛管理护理质量敏感指标提供基础数据.方法 :采用自行设计的儿童疼痛管理实践现状调查问卷分别对全国 66 家医疗机构的护理部主任和科室护士长进行调查.结果:共调查了 33 家综合医院、21 家儿科专科医院和 12 家妇幼保健院,包括 PICU、NICU、儿内科、儿外科、门诊、综合儿科共 492 个科室.其中有 42 家医疗机构(63.64％)开展了儿童疼痛管理.但仅 8 家医疗机构(12.12％)实现了患儿疼痛评估全覆盖,包括全部门诊和住院患儿.39 家医疗机构(59.09％)制定了疼痛管理相关制度或流程.调研科室中,有 300 个科室(60.98％)未进行常规性的疼痛评估.疼痛评估工具和镇痛方法也存在不同程度的差异.结论:目前国内医疗机构尚未做到儿童疼痛管理全覆盖,儿童疼痛管理工作有待进一步规范.有必要建立规范统一的儿童疼痛管理方案或相应指南,提高儿童疼痛管理质量.%Objective: To investigate the current status of children's pain management practice in domestic hospitals, and to provide basic data for the development of sensitive indicators of pain management quality in children. Methods: Directors of nursing department and head nurses in 66 hospitals were recruited with self-designed children's pain management status questionnaires. Results: A total of 33 general hospitals, 21 specialized hospitals and 12 maternal and child health hospitals were investigated, including 492 departments of PICU, NICU, Pediatrics, Pediatric Surgery, Outpatient, and General Hospital Pediatrics. Among them, 42 hospitals (63.64％)carried out child pain management. However, only 8 hospitals (12.12％)achieved full coverage of the child's pain assessment, including all outpatients and hospitalized children. 39 hospitals (59.09％)developed a pain management system. 300 departments (60.98％)did not undergo routine pain assessment. There are also varying degrees of differences in the assessment tools and analgesia methods. Conclusion: Children pain management have not yet fully covered in domestic hospitals. Children's pain management needs to be further regulated. It is necessary to establish a standardized child pain management program or guide to improve the quality of pain management in children.