Improving Pain Management in the Intensive Care Unit by Assessment.

Area of Science:

• Critical Care Medicine
• Nursing Practice
• Pain Management

Background:

• Intensive care unit (ICU) patients experience pain from illness and procedures.
• Assessing pain in non-communicative patients is challenging, risking under- or over-treatment.
• Inadequate pain assessment practices can lead to suboptimal patient care.

Purpose of the Study:

• To evaluate the impact of implementing the Critical-Care Pain Observation Tool (CPOT) on nurses' pain documentation.
• To assess changes in analgesia and sedation administration following CPOT implementation.

Main Methods:

• Quantitative pre-post design study.
• Involved 60 patient records (30 pre-implementation, 30 post-implementation) in a university hospital ICU.
• Utilized the Critical-Care Pain Observation Tool (CPOT) for pain assessment.

Main Results:

• Nurses' pain evaluations increased significantly from 1.3 to 2.3 per shift post-implementation.
• CPOT use improved identification of pain via facial expressions, muscle tension, and ventilator cooperation (p=.014).
• Paracetamol administration increased from 8% pre-CPOT to 17% post-CPOT (p<.01).

Conclusions:

• CPOT implementation enhanced pain assessment frequency and interpretation of patient behaviors.
• Nurses' adherence rate (38%) indicates a need for continuous practice improvement.
• Effective pain management requires integrating CPOT with non-pharmacological and pharmacological interventions and reassessments.