Optimizing nurses' pain assessment of cancer patients in the ICU: a best practice implementation project

Cancer pain remains a major challenge, affecting nearly half of patients-even during treatment. Cancer pain is often under-assessed in the ICU due to communication barriers, limited nurse training, and lack of standardized protocols.

This project aimed to optimize pain assessment by nurses in ICU patients with cancer through the implementation of best practices.

This project followed the seven-phase JBI Evidence Implementation Framework, which is grounded in an audit and feedback strategy. Participants included 26 nurses and 20 ICU patients with cancer. A baseline and follow-up audit were used to measure nurses' accuracy in assessing the patients' pain.

The baseline audit revealed the following compliance metrics: 20.6% for routine assessment of nursing documentation, 52.6% for correct use of the assessment tool, 68% for appropriate pain management when the Visual Analog Scale ≧  3 points or the Behavioral Pain Scale ≧  5 points, and 0% for the detection of cancer pain. In the follow-up audit, these four metrics increased significantly to 100%, 100%, 91.2%, and 70%, respectively.

Leaders can provide education and develop innovative materials to improve nurses' assessment of pain in ICU patients with cancer. Protocols, validated pain tools, on-site checklists, and evidence-based education are effective strategies to enhance nurses' accuracy in assessing cancer pain.

http://links.lww.com/IJEBH/A418.