การพัฒนาระบบงานการจัดการความปวดของหน่วยระงับปวดแบบเฉียบพลัน โรงพยาบาลสรรพสิทธิประสงค์ อุบลราชธานี The Development of Pain Management System for Acute Pain Service in Sunpasitthiprasong Hospital Ubon Ratchathani

บทคัดย่อ

 This action research aimed to develop pain management system for acute pain service and to study the outcome of the developed system for postoperative pain management in Sunpasitthiprasong Hospital Ubon Ratchathani. Study participants include 670 postoperative patients underwent acute pain service and 60 nurse anesthetist. Data were collected by observations, in-depth interview, focus-group discussion and questionnaire during March 2017 to March 2018. Research regulation of Kemmis & Mc Taggart was used in operating procedure, included fours step; 1) Analyzing problem situation and garthering the all result, reflection and brainstorming 2) Creating the plan: this step was preceded by setting up nurse case manager team to develop the Clinical  Nursing Practice Guideline (CNPG) for acute pain management. The nurse case manager and the nursing team werebassigned and defined the roles following the guidelines. 3) Noticing and performing: This step consisted of the performance of nurse case manager and the nursing team, complete of the performance as the Clinical  Nursing Practice Guideline and forwarding the continuing care.                    4) Reflecting the result of the operation: This step was preceded by collecting and analyzing data of the performance as the Clinical  Nursing Practice Guideline. The result of the development from both the hospital staff and the patients. The data were analyzed by using content analysis for qualitative data and descriptive statistic for quantitative data.

                The research outcomes revealed that the nursing system for acute pain management consisted of 1) pain nurse team and  nurse case manager team  2) tool/equipment for acute pain management, such as pain management tools, the clinical  nursing practice guideline for pain management 3) the nursing system for continuing care. The result found that patients that used  pain management with PCA had lower pain scores after surgery. Pain scores at rest ≤ 3 points was increased from 60.74% to 86.70% and pain scores at movement  ≤ 5 points was  increased from 77.46% to 83.50%. The patients satisfaction with acute pain service was in a high level 90%. The nurse anesthetists’s perform followed the CNPG for acute pain management was in a high level (  = 2.0). The nurse anesthetists’ satisfaction with the CNPG was in a high level (  = 4.17).  The knowledge of nurse anesthetists and ward nurse was increased significantly (p<0.00)