Abstract:

Objective To investigate the current status of patient-controlled analgesia（PCA） nursing practices in China and provide a basis for developing standardized PCA nursing procedures. Methods A cross-sectional survey was conducted in May 2025 using a convenience sampling method. A self-designed questionnaire was administered to nurses working in secondary and tertiary hospitals providing PCA services across 31 provinces（autonomous regions and municipalities）. Results A total of 4 675 nurses participated，resulting in a valid response rate of 96.33%. Among them，83.21% reported that their hospitals or departments had established PCA nursing protocols or procedures；69.43% indicated the presence of a PCA multidisciplinary team；70.76% confirmed that PCA nursing quality control was implemented. Regarding clinical application，intravenous PCA was the most commonly used （95.42%），primarily for postoperative pain management（92.32%）. Anesthesiologists were the main personnel responsible for pre-use assessment（70.14%），pump installation（74.20%），and maintenance（60.64%）. The preferred assessment timing for acute pain was “when pain changed or adverse reactions occurred”（73.39%），“shift-based assessment”（68.11%）. Subjective assessment tools remained the primary method for evaluating analgesic efficacy （91.51%）. Documentation of PCA care was required in 80.60% of the departments，and 92.75% of nurses provided patient health education. Major practical issues included insufficient patient assessment（61.69%） and incomplete evaluation of analgesic effects（61.24%）. Key barriers were the lack of standardized protocols/guidelines/procedures （68.81%） and insufficient related knowledge among nurses（66.18%）. Conclusion While PCA nursing protocols have been preliminarily established in Chinese hospitals，multidisciplinary collaboration，quality control，and comprehensive process assessment require further improvement. Nurses’ PCA-related competencies also need further strengthening.

Key words: Pain, Patient Controlled Analgesia, Nursing Care, Current Status Investigation

摘要：

目的 调查住院患者自控镇痛（patient-controlled analgesia，PCA）的护理现状，为进一步规范PCA管理及实践提供依据。方法 采用便利抽样法，于2025年5月使用自制问卷，对31个省（自治区、直辖市）中开展PCA的二级和三级医院护士进行调查。结果 共回收有效问卷4 675份，有效问卷回收率为96.33%。83.21%的护士所在医院或科室已建立PCA护理规范或流程；69.43%的护士所在医院或科室设有PCA管理多学科团队；70.76%的护士所在医院开展了PCA护理质量控制。在PCA临床护理实践中，静脉自控镇痛使用最普遍（95.42%），PCA主要用于术后镇痛（92.32%）；麻醉科医生是使用前评估（70.14%）、泵安装（74.20%）与维护（60.64%）的主要人员；急性、慢性疼痛的首选评估时机分别为疼痛改变或发生不良反应时（73.39%）、每班评估（68.11%），镇痛效果主要采用疼痛主观评估法评估（91.51%）；80.60%的护士所在科室要求书写PCA相关记录；92.75%的护士对患者进行健康教育。PCA主要护理实践问题为患者评估不充分或不准确（61.69%）、镇痛效果评价不全面（61.24%）等，PCA护理实践的主要障碍因素为PCA护理规范、标准或流程缺失（68.81%）、PCA相关知识缺乏（66.18%）等。结论 国内PCA护理管理体系已初步建立，但在多学科协作、质量控制及全流程评估等方面有待完善，护士的实践能力需进一步加强。

关键词: 疼痛, 患者自控镇痛, 护理, 现状调查