Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20200197
Brazilian Journal of Pain
Artigo Original

Impact of educational strategies on pain control quality indicators at a tertiary hospital

Impacto de estratégias educativas nos indicadores de qualidade do controle de dor em um hospital de alta complexidade

Leopoldo Muniz da Silva; Erica Cristina de Paula; Saullo Queiroz Silveira; Arthur de Campos Vieira Abib; Wilson Porfírio de Medeiros Nunes; Helena Harumi Sasaki

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Abstract

BACKGROUND AND OBJECTIVES: Pain management by the multidisciplinary team remains a challenge in the health field. The aim of this study was to analyze the impact of educational strategies for the implementation of pain as the fifth vital sign and its management in a highly complex hospital.

METHODS: An interventional non-controlled study analyzed three different sequential educational processes: Pain training week (PW), educational visits by the pain nurse to guide professionals in relation to pain management and e-learning. The impact of the educational strategy was assessed through pain as the 5th vital sign and adequate pain management.

RESULTS: For pain as the 5th vital sign, the audit previous to PW showed a median of compliance of 46.4% at the inpatient unit, 53.1% at the maternity ward and 16.7% at the emergency room. In the evaluations after PW, the median of compliance at the inpatient unit was 78.4%, at the maternity ward 79.62% and at the emergency room 32.9% (p<0.05). There was an improvement in pain management in all hospital sectors after subsequent training (p<0.05).

CONCLUSION: The implementation of a continuing education program has improved pain care assistance and increased compliance to the institutional pain protocol.

Keywords

Education continuing, Pain, Quality management, Signs and symptoms

Resumo

JUSTIFICATIVA E OBJETIVOS: O manejo da dor pela equipe multidisciplinar continua como um desafio na saúde. O objetivo deste estudo foi analisar o impacto de estratégias educacionais para efetivação da dor como 5º sinal vital e seu gerenciamento em um hospital de alta complexidade.

MÉTODOS: Estudo não controlado de intervenção por meio de análise de três diferentes estratégias educativas sequenciais: Semana de treinamentos sobre Dor (SD), visitas educacionais pelo enfermeiro da dor para orientar os profissionais em relação à dor e treinamento eletrônico virtual de revisão. A análise do impacto das estratégias educativas foi realizada por meio de indicadores em relação à dor como 5º sinal vital e tratamento adequado da dor.

RESULTADOS: Na avaliação da dor como 5° sinal vital, a auditoria prévia à SD mostrou mediana de conformidade de 46,4% na unidade de internação, de 53,1% na maternidade e de 16,7% no Pronto Socorro. Nas avaliações após a SD, a mediana de conformidade na unidade de internação foi de 78,4%, na maternidade de 79,62% e no pronto atendimento de 32,9% (p<0,05). Houve melhora no tratamento da dor em todos os setores após avaliações subsequentes aos treinamentos (p<0,05).

CONCLUSÃO: A implantação de um programa de educação continuada se mostrou efetivo em promover melhora na assistência no cuidado ao paciente com dor e dos resultados dos indicadores assistenciais em relação ao protocolo de dor institucional.

Palavras-chave

Dor, Educação continuada, Gestão da qualidade, Sinais e sintomas

Referências

Dyson J, Lawton R, Jackson C, Cheater F. Development of a theory-based instrument to identify barriers and levers to best hand hygiene practice among healthcare practitioners. Implement Sci. 2013;8:111.

Davidoff F, Dixon-Woods M, Leviton L, Michie S. Demystifying theory and its use in improvement. BMJ Qual Saf. 2015;24(3):228-38.

Hadi MA, Alldred DP, Briggs M, Marczewski K, Closs SJ. Treated as a number, not treated as a person: a qualitative exploration of the perceived barriers to effective pain management of patients with chronic pain. BMJ Open. 2017;7(6).

Nasser SC, Nassif JG, Saad AH. Physicians' attitudes to clinical pain management and education: survey from a Middle Eastern Country. Pain Res Manag. 2016;2016.

Dixon-Woods M, Leslie M, Tarrant C, Bion J. Explaining Matching Michigan: an ethnographic study of a patient safety program. Implement Sci. 2013;8:70.

Berwick DM. The science of improvement. JAMA. 2008;299(10):1182-4.

Evidence scan: Improvement Science. 2011.

Barbosa FF. Estilos de Ensino e Aprendizagem. Rev Escola de Engenharia, UFRS. 1999;85(1):1-7.

Souza MBB, Zem-Mascarenhas SH, Rocha ESB. Percepção dos alunos de graduação sobre a disciplina de administração aplicada à enfermagem. REME - Rev Min Enf. 2005;9(2):140-6.

Allipradini PMZ, Schiavoni A, Mello DE, Sekitani JT. Estratégias de aprendizagem utilizadas por estudantes na educação a distância: implicações educacionais. Psicol Educ. 2014;38:5-16.

Padalino Y, Peres HHC. E-learning: a comparative study for knowledge apprehension among nurses. Rev Lat Am Enfermagem. 2007;15(3):397-403.

Rouleau G, Gagnon MP, Côté J, Payne-Gagnon J, Hudson E, Dubois CA. Effects of E-learning in a continuing education context on nursing care: systematic review of systematic qualitative, quantitative, and mixed-studies reviews. J Med Internet Res. 2019;21(10).

Song W, Eaton LH, Gordon DB, Hoyle C, Doorenbos AZ. Evaluation of evidence-based nursing pain management practice. Pain Manag Nurs. 2015;16(4):456-63.

Alzghoul BI, Abdullah NA. Pain management practices by nurses: an application of the knowledge, attitude, and practices (KAP) model. Glob J Health Sci. 2015;8(6):154-60.

Silva JS, Cruz TA, Ribeiro CJ, Santos VS, Alves JA, Ribeiro MC. Pain in patients attended at risk classification of an emergency service. Rev Dor. 2016;17(1):34-8.

Viveiros WL, Okuno MFP, Campanharo CRV, Lopes MCBT, Oliveira GN, Batista REA. Pain in emergency units: correlation with risk classification categories. Rev Lat Am Enfermagem. 2018;26.

Eshete MT, Baeumler PI, Siebeck M, Tesfaye M, Wonde D, Haileamlak A. The views of patients, healthcare professionals and hospital officials on barriers to and facilitators of quality pain management in Ethiopian hospitals: a qualitative study. PLoS One. 2019;14(3).

Faccioli SC, Tacla MT, Rosseto EG, Collet N. The management of pediatric pain and the perception of the nursing team in light of the social communication model of pain. BrJP. 2020;3(1):37-41.

Hong X, Hui L, Jin L, Yunxia Z, Li L, Hong Z. Pain prevalence and pain management in a Chinese hospital. Med Sci Monit. 2018;24:7809-19.

Van Gulik L, Ahlers SJGM, Bruins P, Tibboel D, van Dijk Knibbe M. Adherence to all steps of a pain management protocol in intensive care patients after cardiac surgery is hard to achieve. Pain Res Manag. 2017;2017.


Submetido em:
03/06/2020

Aceito em:
17/08/2020

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