双闭环管理系统结合关键指标在疼痛管理中的构建及应用

Construction and application of double closed-loop management system combined with key indicators in pain management

摘要:

目的:构建结合关键指标的双闭环管理系统,探讨其在临床疼痛管理中的应用效果。方法:构建双闭环管理系统,包括由疼痛评估、风险预警、医生处置、二次预警及专家会诊模块组成的疼痛管理闭环以及由追踪、审核、统计、分析、整改模块组成的疼痛管理全流程监管闭环,于2023年1月在我院正式应用,比较应用前后6个月疼痛科、肿瘤科、骨科、儿科、重症医学科、烧伤科的疼痛管理关键指标的变化情况。结果:应用双闭环管理系统后,重度疼痛患者疼痛评估准确率由81.80%提高至93.40%、初次预警及时处置率由73.41%提高至91.15%、平均住院日由22.3天降低至17.6天、镇痛满意度由82.4分上升至96.8分,差异均有统计学意义(P<0.001)；轻中度疼痛患者疼痛评估准确率由82.68%提高至94.10%平均住院日由11.1天降低至9.9天、镇痛满意度由83.2分提升至97.5分,差异均有统计学意义(P<0.001)；应用双闭环管理系统后,二次预警及时处置率稳步提高。结论:构建及应用结合关键指标监测的双闭环管理系统,能有效提升疼痛管理各关键节点的质量,优化管理流程,提高患者镇痛满意度,对实现疼痛规范化管理具有重要作用。

Abstract:

Objective: To construct a double closed-loop management system combined with key indicators and explore its application effect in clinical pain management. Methods: The double closed-loop management system was constructed, including the pain management closed-loop composed of pain assessment, risk warning, doctor handling, secondary warning and expert consultation modules, and the whole-process pain management supervision closed-loop composed of tracking, review, statistics, analysis and rectification modules, which was officially applied in our hospital in January 2023, the changes of key indicators of pain management in pain department, oncology department, orthopedics department, pediatrics department, intensive care unit and burn department were compared 6 months before and after application. Results: After the application of the double closed-loop management system, the accuracy rate of pain assessment in patients with severe pain increased from81.80% to 93.40%, the timely treatment rate of initial early warning increased from 73.41% to 91.15%, the average hospitalization time decreased from 22.3 days to 17.6 days, and the analgesic satisfaction increased from 82.4 points to 96.8 points, the differences were statistically significant (P < 0.001); The accuracy rate of pain assessment in patients with mild and moderate pain increased from 82.68% to 94.10%, the average hospitalization time decreased from 11.1 days to 9.9 days, and the analgesic satisfaction increased from 83.2 points to 97.5 points, the differences were statistically significant (P < 0.001); After the application of double closed-loop management system, the timely disposal rate of secondary early warning is gradually improved. Conclusion: The construction and application of double closed-loop management system combined with key indicators monitoring can effectively improve the quality of key nodes of pain management, optimize the management process, improve patients" analgesic satisfaction, and play an important role in realizing standardized pain management.