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Updated: Feb 22, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
[Process for implementing a pain assessment scale for patients with brain injuries: description of a project
Abstract:
Background : in a neurosurgery unit, nurses selected the Critical Pain Observation Tool (CPOT) based on evidence to assess pain in brain-injured patients. However, months after implementation, nursing managers have observed an underutilization.Objectives : support a care team to overcome the pitfalls encountered during the implementation of the CPOT scale for brain-injured patients in neurosurgery unit.Methods : the Lescarbeau, Payette and St-Arnaud's Integrated Model of Consultation was selected. In addition to a scientific literature review, self-administered questionnaire and three interview guides were developed to gather the views of caregivers.Results : the process allowed to identify pitfalls at level of interprofessional collaboration CPOT scale and implementation processes. Improving interprofessional collaboration and adaptation of CPOT scale for brain-injured patients were withholding action priorities.Discussion : a rigorous methodology, the mutual recognition of clinical skills and the development of relationship of trust are prerequisites for the success of clinical innovation.Conclusion : the Integrated Intervention Model is a methodology of choice allowing to take into consideration both evidence and preferences of all actors at every step of the process led to informed choices and priorities setting for a successful implementation.

