Patient Satisfaction and Documentation of Pain Assessments and Management After Implementing the Adult Nonverbal Pain Scale

Behavioral Pain Assessment Tool for Critically Ill Adults Unable to Self-Report Pain

“…The rate was also a marked improvement from compliance at baseline. A similar compliance rate for documented pain assessment was reported by Topolovec-Vranic et al, 13 whereas Gélinas et al 14 reported a median of 12 documented assessments (every 2 hours) per 24 hours of ICU stay 12 months after CPOT implementation, although compliance cannot be calculated because institutional recommendations for frequency of documentation were not described.…”

“…In a large multicenter observational study, 12 pain assessment was associated with reductions in the duration of mechanical ventilation and ICU stay. In a small study 13 involving patients in a neurotrauma ICU, introduction of the Nonverbal Pain Scale 9 increased documentation of pain assessments and decreased recalled severity of the pain patients experienced. More recently, Gélinas et al 14 reported increased pain documentation and decreased administration of analgesic and sedative agents after introduction of the Critical-Care Pain Observation Tool (CPOT) in a small mixed ICU population (30 patients before, 30 at 3 months, and 30 at 12 months after implementation).…”

Observational Pain Scales in Critically Ill Adults

“…Finally, Topolovec-Vranic et al 25 found that implementation of the NVPS was associated with a trend toward decreased levels of severe pain (55% vs 35% of patients reporting severe pain), although these findings were not statistically significant, and increased frequency of pain assessment (29% vs 59%; P < .001). The investigators 25 acknowledged that the trend may have been due to an increased awareness of the need to assess pain after the Table 2 Adult Nonverbal Pain Scale Abbreviations: HR, heart rate; RR, respiratory rate; SBP, systolic blood pressure; SpO 2 , pulse oximetry.…”

“…The routine assessment of pain with an observational pain assessment instrument can decrease ICU length of stay; decrease the duration of mechanical ventilation; and increase the satisfaction of patients, patients' family members, and health care providers. 4,25 Of the available observational pain scales, the CPOT has shown superior reliability and validity when used in nonverbal critically ill adults. However, the CPOT should be used cautiously in evaluating patients who have chronic pain or concurrent delirium.…”

“…The investigators 25 acknowledged that the trend may have been due to an increased awareness of the need to assess pain after the Table 2 Adult Nonverbal Pain Scale Abbreviations: HR, heart rate; RR, respiratory rate; SBP, systolic blood pressure; SpO 2 , pulse oximetry. Instructions: Each of the 5 categories is scored from 0-2, which results in a total score between 0 and 10.…”