Implementation of a pain management algorithm in intensive care units and evaluation of nurses' level of adherence with the algorithm

Olsen, Brita Fosser; Rustøen, Tone; Sandvik, Leiv; Miaskowski, C.; Jacobsen, Morten; Valeberg, Berit Taraldsen

doi:10.1016/j.hrtlng.2015.08.001

Cited by 29 publications

(29 citation statements)

References 32 publications

(36 reference statements)

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“…To design the educational content, we carried out an extensive, systematic review of pain management algorithms and programs in intensive care units. One study was selected that, compared to other studies, had appropriate indicators: having brief steps, easy clinical application, proper valid pain diagnosis scales, and assessment pain scale in patients with or without intubation ( 32 ). Then, due to the lack of transparency in the implementation process of therapeutic interventions in the existing algorithm, WHO and Shahriari et al’s ( 33 ) pain control models were used to make the algorithm more understandable.…”

Section: Methodsmentioning

confidence: 99%

Effect of Comprehensive Pain Management Training Program on Awareness and Attitude of ICU Nurses

et al. 2020

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Background: Pain is one of the main complaints of many patients in intensive care units. However, most nurses and physicians are unable to properly monitor and relieve pain in these patients. Factors such as patients' inability to describe their pain and insufficient knowledge of nurses and physicians have made pain management difficult. Given that the knowledge and attitude of nurses play an important role in the effective implementation of the pain management process, this study aimed to investigate the effect of comprehensive pain management training program on the awareness and attitude of intensive care unit nurses. Methods: This quasi-experimental single-group study was conducted in two phases (pre and post-intervention) to investigate the awareness and attitude of all nurses employed in the intensive care unit of Tehran Modarres Hospital, based on the determined inclusion and exclusion criteria. In the pre-intervention phase, the awareness and attitudes of the nurses were assessed using a questionnaire. After conducting the pain management training course, an executive program and algorithm were implemented for pain management in ICUs. Then, the nurses' awareness and attitude toward pain management were assessed again. Finally, changes in the scores of the nurses' awareness and attitude were analyzed by SPSS V. 22 software in two phases before and after applying the interventions using the Wilcoxon test. The relationship between some demographic variables and the level of awareness and attitude of nurses was also investigated using the Kruskal-Wallis and Mann-Whitney tests. Results: The results of this study indicated that the mean score of the nurses' awareness was significantly different in pre-and postintervention phases (P < 0.05). Despite an increase in the post-intervention mean score of the nurses' attitude (71.03), no statistically significant change was observed. Additionally, among the demographic variables, there was only a significant relationship between the nurses' job experience in ICUs and their attitudes. Conclusions: Based on the results of this study, teaching and implementing a comprehensive program for pain management can play an effective role in promoting the nurses' awareness. Therefore, it is proposed to use pain management models to improve the nurses' knowledge and attitude toward pain management in ICU patients.

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Section: Methodsmentioning

confidence: 99%

Effect of Comprehensive Pain Management Training Program on Awareness and Attitude of ICU Nurses

et al. 2020

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“…Although the BPS was found to be valid, reliable and easy to use, an intense awareness campaign and training for healthcare professionals is imperative for its use to be consistent, efficient and effective. ( 38 , 39 ) In addition, the development and implementation of protocols and clinical guidelines for care centered on the comfort of critical patients are crucial for humanization and improving the quality of care. ( 40 )…”

Section: Discussionmentioning

confidence: 99%

Pain assessment of traumatic brain injury victims using the Brazilian version of the Behavioral Pain Scale

Ribeiro

Araújo

Brito

et al. 2018

Revista Brasileira De Terapia Intensiva

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ObjectiveTo evaluate the validity and reliability of the Brazilian version of the Behavioral Pain Scale (BPS-Br) in victims of traumatic brain injury.MethodsObservational prospective study with paired and repeated measures conducted at two intensive care units (clinical and surgical) of a large general hospital. The convenience sample consisted of adult victims of moderate or severe penetrating or blunt craniocerebral trauma who were sedated and mechanically ventilated. A total of 432 paired observations were performed by independent evaluators simultaneously, prior to eye cleaning, during eye cleaning, during tracheal aspiration and after tracheal aspiration. Sociodemographic, clinical, trauma-related, sedoanalgesia and physiological parameter data (heart rate, systolic and diastolic blood pressure) were collected. The discriminant validity was tested using the Friedman and Wilcoxon paired tests. The intraclass correlation coefficient and Cohen's Kappa coefficient were used to evaluate the reliability. The Spearman correlation test was used to test the association between clinical variables and BPS-Br scores during tracheal aspiration.ResultsThere was a significant increase in the physiological parameters during tracheal aspiration, but without correlation with the BPS-Br scores. Pain was significantly more intense during tracheal aspiration (p < 0.005). Satisfactory interobserver agreement was found, with an intraclass correlation coefficient of 0.95 (0.90 - 0.98) and Kappa coefficient of 0.70.ConclusionBrazilian version of the Behavioral Pain Scale scores increased during tracheal aspiration. The Brazilian version of the scale was valid and reliable for pain assessment of traumatic brain injury victims undergoing tracheal aspiration.

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“…8,14,15,17,18,22,23,25,41,42 This partially could be the result of considerably lower ICC values during rest (fair-to-moderate) compared with the procedures (moderate-to-almost perfect), which was contrary to several previous studies. 8,10,[21][22][23]26,43 ICC values are assumed to be susceptible to between-subject variability, and a lack of subject variability can cause incorrect low ICC values. 34,44 A minority of the validation studies have assessed only patients after cardiac surgery, which likely were more homogenous populations in terms of diagnosis, age, severity of illness, pain and level of sedation, and analgesia than that of a general ICU population or a mixed medical/ surgical population.…”

Section: Discussionmentioning

confidence: 99%

Pain Measurement in Mechanically Ventilated Patients After Cardiac Surgery: Comparison of the Behavioral Pain Scale (BPS) and the Critical-Care Pain Observation Tool (CPOT)

Rijkenberg

Stilma

Bosman

et al. 2017

Journal of Cardiothoracic and Vascular Anesthesia

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Implementation of a pain management algorithm in intensive care units and evaluation of nurses' level of adherence with the algorithm

Abstract: ICU nurses can use a pain management algorithm consistently. Findings from this study suggest that a pain management algorithm is a useful tool to increase ICU nurses' adherence with pain assessment.

Cited by 29 publications

References 32 publications

Effect of Comprehensive Pain Management Training Program on Awareness and Attitude of ICU Nurses

Effect of Comprehensive Pain Management Training Program on Awareness and Attitude of ICU Nurses

Pain assessment of traumatic brain injury victims using the Brazilian version of the Behavioral Pain Scale

Pain Measurement in Mechanically Ventilated Patients After Cardiac Surgery: Comparison of the Behavioral Pain Scale (BPS) and the Critical-Care Pain Observation Tool (CPOT)

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