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Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

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Implementing an Evidence-Based Functional Pain Assessment Scale in an Adult Inpatient Unit.

Allison Hanson¹, Seth Jackson², Elyse Laures²

¹From the University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242; Iowa City VA Medical Center, Iowa City, Iowa.

Pain Management Nursing : Official Journal of the American Society of Pain Management Nurses

|April 15, 2024

Summary

Implementing a Functional Pain Scale (FPS) improved pain assessment and management in cardiothoracic patients. Patients preferred the FPS, finding it easy to use and enhancing their understanding of pain management plans.

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Area of Science:

Nursing
Pain Management
Evidence-Based Practice

Background:

Traditional one-dimensional pain scales present challenges in accurately assessing and managing patient pain.
Issues include perceived ineffective pain management, inadequate control of chronic pain, and confusion regarding pain intensity scores between patients and healthcare teams.

Purpose of the Study:

To describe an evidence-based practice project focused on enhancing pain assessment.
Implementation of a Functional Pain Scale (FPS) on an adult inpatient cardiothoracic unit was the core objective.

Main Methods:

The project utilized the Iowa Model-Revised and Implementation Strategies for Evidence-Based Practice Guide.
Strategies included staff and patient education, policy revision, and electronic health record integration.
Evaluation involved pre- and post-implementation patient and staff surveys.

Main Results:

Over 75% of patients preferred the Functional Pain Scale (FPS), with most finding it easy to use.
Nurses reported improved perception of documentation completeness and accuracy.
Nurses also noted enhanced patient understanding of their pain management plans.

Conclusions:

The Functional Pain Scale (FPS) can be successfully integrated into nursing workflows.
The FPS shifts pain management focus from intensity reduction to achieving care goals, aligning expectations, and fostering a common language between patients and providers.