疼痛护理管理2014.ppt

华山的经验和对策 疼痛管理质量 良好习惯 及时识别并治疗疼痛 测量（自我报告）并记录疼痛及其缓解曲线 监测过程与结果 从患者及其他来源获取信息 承诺细心照顾，提供相关信息 熟悉疼痛相关处理的政策规范 不断完善过程及结果管理 放松。意象，催眠 安抚 精神慰藉 解决问题与设定目标 减轻疼痛，改善功能，提高生活质量 NRS的疼痛评分小于等于3分或达到0分 24小时突发性疼痛次数少于3次 24小时内需要解救药的次数小于3次 国外 睡眠时无痛 静止时无痛 活动时无痛 疼痛管理发展趋势 专业化、专职化：专科护士/专职护士 网络化、规范化：专委会/国际认证 团队协作、共同参与：纵向/横向 国际协作、共解难题：资源共享 人生几何，能够为一个身心被病魔折腾的人送上一剂止痛药、 一丝温暖、 一份爱心， 使他们肉体上的苦痛立竿见影地消失，心灵同时得到滋润，这是何等尊贵的工作 李嘉诚先生 谢谢聆听！ 愿景：患者在无痛或尽可能轻的痛苦中获得治疗和康复锻炼 目标：减轻或消除疼痛 难点: 镇痛不仅仅是用止痛药 阻碍：各级人员明确职责、疼痛知识的培训、医护患协作 讨论 目前遇到的困难、管理上的问题 医生患者对疼痛管理的参与程度？ 目前方案：应根据患者的疾病、疼痛的性质，在基础方案上调整的可行性？ 评估与反馈 住院期间疼痛满意度测评？ 教育平台 相对缺乏！ 讨论 * Note: The inability to communicate verbally does not negate the possibility that an individual is experiencing pain and is in need of appropriate pain-relieving treatment. Notes: Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life. Biologists recognize that those stimuli which cause pain are liable to damage tissue. Accordingly, pain is that experience we associate with actual or potential tissue damage. It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional experience. Experiences which resemble pain but are not unpleasant, e.g., pricking, should not be called pain. Unpleasant abnormal experiences (dysesthesias) may also be pain but are not necessarily so because, subjectively, they may not have the usual sensory qualities of pain. Many people report pain in the absence of tissue damage or any likely pathophysiological cause; usually this happens for psychological reasons. There is usually no way to distinguish their experience from that due to tissue damage if we take the subjective report. If they regard their experience as pain and if they report it in the same ways as pain caused by tissue damage,