PDF(Pubmed)
Abstract：
UNASSIGNED: Surgical populations and particularly injury survivors often present with complex trauma that elevates their risk for prolonged opioid use and misuse. Changes in opioid prescribing guidelines during the past several years have yielded mixed results for pain management after trauma, with a limiting factor being the heterogeneity of clinical populations and treatment needs in individuals receiving opioids. The present analysis illuminates this gap between clinical guidelines and clinical practice through qualitative feedback from hospital trauma providers and unit staff members regarding current opioid prescribing guidelines and practices in the setting of traumatic injury.
UNASSIGNED: The parent study aimed to implement a pilot screening tool for opioid misuse in four level I and II trauma hospitals throughout Wisconsin. As part of the parent study, focus groups were conducted at each study site to explore the facilitators and barriers of implementing a novel screening tool, as well as to examine the current opioid prescribing guidelines, trainings, and resources available for trauma and acute care providers. Focus group transcripts were independently coded and analyzed using a modified grounded theory approach to identify themes related to the facilitators and barriers of opioid prescribing guidelines in trauma and acute care.
UNASSIGNED: Three major themes were identified as impactful to opioid-related prescribing and care provided in the setting of traumatic injury; these include (1) acute treatment strategies; (2) patient interactions surrounding pain management; and (3) the multifactorial nature of trauma on pain management approaches.
UNASSIGNED: Providers and staff at four Wisconsin trauma centers called for trauma-specific opioid prescribing guidelines in the setting of trauma and acute care. The ubiquitous prescription of opioids and challenges in long-term pain management in these settings necessitate additional community-integrated research to inform development of federal guidelines.
UNASSIGNED: Therapeutic/care management, level V.
UNASSIGNED: The parent study aimed to implement a pilot screening tool for opioid misuse in four level I and II trauma hospitals throughout Wisconsin. As part of the parent study, focus groups were conducted at each study site to explore the facilitators and barriers of implementing a novel screening tool, as well as to examine the current opioid prescribing guidelines, trainings, and resources available for trauma and acute care providers. Focus group transcripts were independently coded and analyzed using a modified grounded theory approach to identify themes related to the facilitators and barriers of opioid prescribing guidelines in trauma and acute care.
UNASSIGNED: Three major themes were identified as impactful to opioid-related prescribing and care provided in the setting of traumatic injury; these include (1) acute treatment strategies; (2) patient interactions surrounding pain management; and (3) the multifactorial nature of trauma on pain management approaches.
UNASSIGNED: Providers and staff at four Wisconsin trauma centers called for trauma-specific opioid prescribing guidelines in the setting of trauma and acute care. The ubiquitous prescription of opioids and challenges in long-term pain management in these settings necessitate additional community-integrated research to inform development of federal guidelines.
UNASSIGNED: Therapeutic/care management, level V.
摘要：
■手术人群，尤其是受伤幸存者，通常会出现复杂的创伤，这增加了长期使用和滥用阿片类药物的风险。在过去几年中，阿片类药物处方指南的变化对创伤后的疼痛管理产生了不同的结果，限制因素是临床人群的异质性和接受阿片类药物的个体的治疗需求。本分析通过医院创伤提供者和单位工作人员对当前阿片类药物处方指南和创伤背景下的实践的定性反馈，阐明了临床指南与临床实践之间的差距。
■这项研究旨在在威斯康星州的四个一级和二级创伤医院中实施阿片类药物滥用的试点筛查工具。作为家长研究的一部分，在每个研究地点进行了焦点小组，以探索实施新型筛查工具的促进者和障碍，以及检查当前的阿片类药物处方指南，培训,以及创伤和急性护理提供者可用的资源。使用改良的扎根理论方法对焦点小组的转录本进行独立编码和分析，以确定与创伤和急性护理中阿片类药物处方指南的促进者和障碍相关的主题。
■确定了三个主要主题，这些主题对创伤性损伤中与阿片类药物相关的处方和护理有影响；这些主题包括（1）急性治疗策略；（2）围绕疼痛管理的患者相互作用；（3）创伤对疼痛管理方法的多因素性质。
■威斯康星州四个创伤中心的提供者和工作人员呼吁在创伤和急性护理中制定创伤特异性阿片类药物处方指南。阿片类药物的普遍处方和这些环境中长期疼痛管理的挑战需要额外的社区综合研究来指导联邦指南的制定。
■治疗/护理管理，V级
■这项研究旨在在威斯康星州的四个一级和二级创伤医院中实施阿片类药物滥用的试点筛查工具。作为家长研究的一部分，在每个研究地点进行了焦点小组，以探索实施新型筛查工具的促进者和障碍，以及检查当前的阿片类药物处方指南，培训,以及创伤和急性护理提供者可用的资源。使用改良的扎根理论方法对焦点小组的转录本进行独立编码和分析，以确定与创伤和急性护理中阿片类药物处方指南的促进者和障碍相关的主题。
■确定了三个主要主题，这些主题对创伤性损伤中与阿片类药物相关的处方和护理有影响；这些主题包括（1）急性治疗策略；（2）围绕疼痛管理的患者相互作用；（3）创伤对疼痛管理方法的多因素性质。
■威斯康星州四个创伤中心的提供者和工作人员呼吁在创伤和急性护理中制定创伤特异性阿片类药物处方指南。阿片类药物的普遍处方和这些环境中长期疼痛管理的挑战需要额外的社区综合研究来指导联邦指南的制定。
■治疗/护理管理，V级
