Study On The Construction And Application Of Pain Management Plan For Patients With Discogenic Low Back Pain Based On Evidence-based Practice

Objective:On the basis of evidence-based nursing practice,scientific and systematic literature search is conducted to summarize the best evidence and initially construct a nursing management plan for discogenic low back pain.To conduct a preliminary evaluation of the effectiveness of the management plan for discogenic low back pain,and to apply the management plan in a scientific and efficient manner in clinical practice to optimize pain care management methods,promote standardized and scientific pain care processes,and alleviate patient pain.Methods:This study is based on evidence-based nursing,through systematic search by the research team,summarizes the best evidence,and initially develops a nursing management plan for discogenic low back pain.2.Hold an expert meeting to modify and improve the plan through expert argumentation,and build a complete management plan for discogenic low back pain.3.Establish an evidence review team,apply the i-PARIHS theoretical framework to guide the clinical application of the management plan for discogenic low back pain,and use quasi experimental research methods to analyze and compare the research results at the three levels of nurses,patients,and systems.Results:Through literature search,screening,and evaluation by the research team,the final included documents were 2 clinical decision-making articles,6 guidelines,2systematic evaluations,and 2 expert consensus articles.2.Summarize the best evidence from the included literature,revise and improve the evidence content through expert meeting modifications and discussion among members of the research group,and ultimately form a pain management plan for patients with discogenic low back pain,including 4 first level items,12 second level items,and 29 third level items.In this study,under the guidance of evidence-based nursing practice and i-PARIHS theory,the pain management program has achieved certain results at three levels: nurses,patients,and the system.At the nurse level:(1)In terms of nurses’ mastery of the pain management and pain assessment test questions for discogenic low back pain,the score of knowledge related to discogenic low back pain increased from(6.25±4.33)points before the application of the evidence to(21.67±5.37)points after the application of the evidence;The score of pain assessment knowledge increased from(14.58±5.42)before the application of evidence to(23.33±5.77)after the application of evidence;The total assessment score increased from(42.08±11.57)before the application of evidence to(68.75±8.56)after the application of evidence,with a statistically significant difference(P<0.05).(2)Nurses’ compliance with the quality review of nursing care for discogenic low back pain has improved to a certain extent,and there is a statistically significant difference in compliance before and after the application of each item of evidence(P<0.05).At the patient level:(1)After the application of evidence,the hospitalization days of patients were somewhat shorter than before,from(6.87±1.49)days to(4.74±0.91)days,with a statistically significant difference(P<0.05).(2)The pain scores of the two groups of patients were analyzed using repeated measurement analysis of variance before and after the application of evidence.The results showed that there was a significant decrease in pain scores after the application of evidence at three time nodes: the day of admission,the day of discharge,and one month after discharge,with a statistically significant difference(P<0.05).At the system level:(1)A pain care quality review form for patients with discogenic low back pain in the pain department was constructed to improve the quality of pain care management among nurses;(2)Conducting pain specialist knowledge training to improve and guide nursing staff to better manage pain care;(3)Establish an evidence review management team to conduct quality control to improve the implementation efficiency of nursing staff.Conclusion:1.This study summarizes the best existing evidence on the management of discogenic low back pain,including 4 first level items,12 second level items,and 29 third level items for evaluation and diagnosis,health education,prevention management,and non drug management.It has been modified and improved through expert meetings,with scientific,comprehensive,and practical content.2.Under the guidance of i-PARIHS theory,this study effectively promoted the conversion of evidence through baseline surveys before and after the application of evidence.At the same time,the three levels of nursing staff,patients,and system were used as observation indicators for the effectiveness of the study,enriching nurses’ pain management knowledge,standardizing nurses’ pain evaluation procedures,improving department pain management,and effectively reducing patients’ pain level.