Application Research Of NRS-based Practical Training In Improving Pain Behavior Observation Ability Of Orthopaedic Nurses

Objective(s):To investigate the accuracy and homogenization status of orthopedic nurses’objective pain behavior observation;to explore the effect of Numeric Rating Scale(NRS)-based practical training on the orthopaedic nurses’ capability of objective pain behavior observation.Observing the accuracy and homogenization effect of improving the observation of pain behavior in clinical nurses,provide clinical trial basis for the clinical application and training practice of the objective pain assessment scale.Methods:In this study,53 nurses who met the inclusion criteria in a top three hospital in Kunming,Yunnan Province were selected as subjects.They all evaluated patients’pain by the Adult Pain Behavioral Scale(APBS).From March 2018 to December 2018,344 patients with bone trauma who met the inclusion criteria were enrolled to completed the study as subject to be evaluated.Both the study subject and the evaluated subject obtained informed consent.1.Investigation on the application status of orthopedic nurses’ pain behavior observation:Accuracy:From March to April 2018,53 nurses in the Department of Orthopaedics performed APBS and NRS scores on all 184 patients who met the inclusion criteria.The random figure table was used to extract 50 cases.After data collection,the correlation between APBS score from the nurse and NRS score from the patient was analyzed,and the Pearson Correlation Coefficient r was calculated.Homogenization:5 nurses were randomized extracted to assess pain of 20 patients who met the inclusion criteria using APBS,a total of 100 cases.The score of each item and the sum was collected to analyze the homogenization degree of the items and the total score,by means of the Intraclass Correlation Coefficient,ICC’s calculation。2.NRS-based practical training:Practical training includes three parts:centralized theoretical training,group discussion style clinical practice with reference to patient NRS score,application examination.The training time was 6 months.3.Investigation on the application of pain behavior observation in orthopedic nurses after practical training:The survey method is the same as before.Results:1.After training,the accuracy of APBS assessment is significantly higher than before.The r of APBS and NRS before and after training were 0.571 and 0.840 respectively.2.After training,the homogenization of each item score and the sum of APBS was significantly higher than before.The ICC of Facial expression before and after training were 0.617,0.841 respectively;the ICC of Rest state before and after training were 0.206,0.745 respectively;The ICC of Muscle tension before and after training were 0.244,0.775 respectively;the ICC of Consolability before and after training were 0.590,0.864 respectively.The ICC of Vocalization before and after training were 0.310,0.804 respectively.The ICC of Sum before and after training were 0.416,0.822 respectively.Conclusion(s):1.Both the Accuracy and homogenization of the Orthopedic nurse’ s pain behavior observation is at a low status.2.NRS-based practical training has a positive impact on the ability of the nurse’s pain behavior observation,which significantly improved the accuracy and homogenization of the nurse’s pain behavior observation.