Video education for critical care nurses to assess pain with a behavioural pain assessment tool: A descriptive comparative study

BACKGROUND: Postoperative pain is one of the major obstacles in the prevention of complications during patient recovery. Pain and its management have gained great interest among researchers, clinicians and policy-makers. PURPOSES: To explore the relationship between two variables in pain assessment (length of time after surgery and ventilator status) and medication decisions made by critical care nurses, and to identify nurses' concerns about opioid use. METHODS: A convenience sample of 71 critical care nurses participated in the survey. RESULTS: Certain patient conditions such as length of time after surgery and ventilator status affected nurses' assessment and management of pain. Nurses' knowledge about pain assessment and management may affect patient care and outcomes.

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Computerized clinical simulations: a strategy for staff development in critical care

American Journal of Critical Care ◽

10.4037/ajcc1992.1.2.99 ◽

1992 ◽

Vol 1 (2) ◽

pp. 99-107 ◽

Cited By ~ 5

Author(s):

SB Henry ◽

D Waltmire

Keyword(s):

Critical Care ◽

Staff Development ◽

Assessment Tool ◽

Critical Care Nurses ◽

Knowledge Assessment ◽

Basic Knowledge ◽

Learning Needs ◽

Evaluation Tool ◽

Self Evaluation ◽

Clinical Simulations

BACKGROUND: Identifying the learning needs of employees and evaluating the results of staff development offerings are essential elements of the responsibilities of the staff development educator. High patient acuity, the shortage of critical care nurses, and rapidly changing technology within the critical care environment demand the provision of staff development offerings that are appropriate for the learning needs of critical care nurses and the evaluation of the effect of programs on critical care nursing practice. OBJECTIVE: The purposes of this descriptive, correlational study were to compare the ability of a knowledge test, a self-evaluation tool, and computerized clinical simulations to discriminate between nurses with varied levels of knowledge and experience, and to compare the learning needs identified from the three types of evaluative instruments. METHODS: Each subject (n = 142) completed the Basic Knowledge Assessment Tool for Critical Care, Cardiovascular Self-Evaluation Tool, and four computerized clinical simulations. RESULTS: Both the Basic Knowledge Assessment Tool and the Cardiovascular Self-Evaluation Tool discriminated between experienced/inexperienced and Advanced Cardiac Life Support-certified/noncertified critical care nurses. The computerized clinical simulations discriminated according to Advanced Cardiac Life Support certification, but not between experienced and inexperienced critical care nurses. The computerized clinical simulations identified more specific learning needs than did the Basic Knowledge Assessment Tool or Cardiovascular Self-Evaluation Tool. CONCLUSIONS: The evidence for discriminant validity, adequate internal consistency reliability, and ease of administration supports the continued use of these two tools as methods for critical care staff development needs assessment and evaluation. In addition, the study findings support the use of computerized clinical simulations as an adjunct to other needs assessment and evaluation methods in nursing staff development.

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Measuring paediatric intensive care nursing knowledge in Australia and New Zealand: How the Basic Knowledge Assessment Tool for pediatric critical care nurses (PEDS-BKAT4) performs

Australian Critical Care ◽

10.1016/j.aucc.2012.02.004 ◽

2013 ◽

Vol 26 (1) ◽

pp. 36-42 ◽

Cited By ~ 5

Author(s):

Debbie Long ◽

Jeanine Young ◽

Claire M. Rickard ◽

Marion L. Mitchell

Keyword(s):

Critical Care ◽

Intensive Care ◽

Assessment Tool ◽

Critical Care Nurses ◽

Knowledge Assessment ◽

Basic Knowledge ◽

Pediatric Critical Care ◽

Nursing Knowledge ◽

Intensive Care Nursing ◽

Care Nursing

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Use of PADIS Assessment Tools by Critical Care Nurses: An Integrative Review

Western Journal of Nursing Research ◽

10.1177/0193945920973025 ◽

2020 ◽

pp. 019394592097302

Author(s):

Denise Waterfield ◽

Susan Barnason

Keyword(s):

Critical Care ◽

Assessment Tool ◽

Reasoned Action ◽

Final Analysis ◽

Critical Care Nurses ◽

Assessment Tools ◽

Integrative Review ◽

Control Beliefs ◽

Reasoned Action Approach ◽

Patient Centered

The purpose of this integrative review was to evaluate the literature from January 2013 to April 2020 and to explore critical care nurses’ perspectives of and intent to use recommended Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) patient assessment tools in adult critical care units. A literature search was performed with a total of 47 studies included in the final analysis for this review. The studies’ data were organized and further reduced based on The Reasoned Action Approach behavioral theory to reflect the extent to which a nurse plans to use a PADIS assessment tool. Extracted themes were related to behavioral beliefs in patient-centered care and critical thinking; normative beliefs about communication and prioritization; and control beliefs concerning autonomy and confidence. Contextualizing the international phenomenon of variation in PADIS assessment tool use by critical care nurses provides a deeper understanding of its complexity for use in the clinical setting.

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Pain Management in the Critically Ill: What Do We Know and How Can We Improve?

AACN Advanced Critical Care ◽

10.4037/15597768-1994-2008 ◽

1994 ◽

Vol 5 (2) ◽

pp. 159-168 ◽

Cited By ~ 2

Author(s):

Michele A. Alpen ◽

Marita G. Titler

Keyword(s):

Critical Care ◽

Quality Improvement ◽

Pain Management ◽

Critically Ill ◽

Pain Assessment ◽

Pain Control ◽

Critical Care Nurses ◽

Critical Care Units ◽

Knowledge And Attitudes ◽

Nurses Knowledge

Pain management in the critically ill is a challenge and a problem of great concern for critical care nurses. The authors review research on pain in the areas of pain assessment, nurses’ knowledge and attitudes, pharmacologic interventions, and nonpharmacologic interventions for the management of pain. Although the research base is not completely developed in the critically ill population, implications for practice are provided, based upon the findings in populations akin to the critically ill. Strategies are outlined for achieving improved pain control in critical care units through education, adoption of standards on pain management, and quality improvement activities

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Using the Model for Improvement to implement the Critical-Care Pain Observation Tool in an adult intensive care unit

BMJ Open Quality ◽

10.1136/bmjoq-2017-000304 ◽

2018 ◽

Vol 7 (4) ◽

pp. e000304 ◽

Cited By ~ 1

Author(s):

Mairi Mascarenhas ◽

Michelle Beattie ◽

Michelle Roxburgh ◽

John MacKintosh ◽

Noreen Clarke ◽

...

Keyword(s):

Intensive Care Unit ◽

Critical Care ◽

Intensive Care ◽

Pain Assessment ◽

Best Practice ◽

Assessment Tool ◽

Assessment Tools ◽

Self Report ◽

Process Measures ◽

Adult Intensive Care Unit

Managing pain is challenging in the intensive care unit (ICU) as often patients are unable to self-report due to the effects of sedation required for mechanical ventilation. Minimal sedative use and the utilisation of analgesia-first approaches are advocated as best practice to reduce unwanted effects of oversedation and poorly managed pain. Despite evidence-based recommendations, behavioural pain assessment tools are not readily implemented in many critical care units. A local telephone audit conducted in April 2017 found that only 30% of Scottish ICUs are using these validated pain instruments. The intensive care unit (ICU) at Raigmore Hospital, NHS Highland, initiated a quality improvement (QI) project using the Model for Improvement (MFI) to implement an analgesia-first approach utilising a validated and reliable behavioural pain assessment tool, namely the Critical-Care Pain Observation Tool (CPOT). Over a six-month period, the project deployed QI tools and techniques to test and implement the CPOT. The process measures related to (i) the nursing staff’s reliability to assess and document pain scores at least every four hours and (ii) to treat behavioural signs of pain or CPOT scores ≥ 3 with a rescue bolus of opioid analgesia. The findings from this project confirm that the observed trends in both process measures had reduced over time. Four hourly assessments of pain had increased to 89% and the treatment of CPOT scores ≥3 had increased to 100%.

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