550: THE VALIDITY OF VITAL SIGNS FOR PAIN ASSESSMENT IN CRITICALLY ILL ADULTS

This is an updated, comprehensive review of the psychometric properties of behavioral pain assessment tools for use with noncommunicative, critically ill adults. Articles were searched in 5 health databases. A total of 106 articles were analyzed, including 54 recently published papers. Nine behavioral pain assessment tools developed for noncommunicative critically ill adults and 4 tools developed for other non-communicative populations were included. The scale development process, reliability, validity, feasibility, and clinical utility were analyzed using a 0 to 20 scoring system, and quality of evidence was also evaluated. The Behavioral Pain Scale, the Behavioral Pain Scale-Nonintubated, and the Critical-Care Pain Observation Tool remain the tools with the strongest psychometric properties, with validation testing having been conducted in multiple countries and various languages. Other tools may be good alternatives, but additional research on them is necessary.

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Effect of Interhospital ICU Relocation on Patient Physiology and Clinical Outcomes

Journal of Intensive Care Medicine ◽

10.1177/0885066617726754 ◽

2017 ◽

Vol 34 (11-12) ◽

pp. 1010-1016 ◽

Cited By ~ 2

Author(s):

David R. Janz ◽

Yasin A. Khan ◽

Jennifer L. Mooney ◽

Matthew W. Semler ◽

Todd W. Rice ◽

...

Keyword(s):

Clinical Outcomes ◽

Critically Ill ◽

Invasive Mechanical Ventilation ◽

Vital Signs ◽

Inhospital Mortality ◽

Device Removal ◽

Interhospital Transport ◽

Before And After ◽

Critically Ill Adults ◽

Ill Adults

Relocation of large numbers of critically ill patients between hospitals is sometimes necessary and the risks associated with relocation may be high. In the setting of adherence to an interhospital intensive care unit (ICU) relocation protocol, we aimed to determine whether the interhospital relocation of all ICU patients in a single day is associated with changes in vital signs, device removal, and worse clinical outcomes. We conducted a prospective, observational, cohort study of all critically ill adults admitted to a tertiary medical center’s ICUs on the day of a planned hospital relocation and exposed to interhospital ICU relocation compared with unexposed critically ill adults. Changes in vital signs were evaluated by the before-and-after interhospital relocation measurement of vital signs, and clinical outcomes were collected for all patients. A total of 699 patients were admitted to the ICU during the observation period, 24 of whom were exposed to interhospital ICU relocation on a single day. The median interhospital transport duration was 28 minutes (interquartile range: 24-35) and 29% of patients were receiving invasive mechanical ventilation. Patients exposed to interhospital ICU relocation had no significant change in any vital sign measurement and no devices were unintentionally removed. Inhospital mortality was similar (8.3%) to patients not exposed to interhospital ICU relocation (9.2%, P > .99). In the setting of adherence to an ICU relocation protocol, the interhospital ICU relocation of all critically ill adults during a single day is not associated with changes in vital signs, device removal, or worse clinical outcomes.

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