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

1994 ◽  
Vol 5 (2) ◽  
pp. 159-168 ◽  
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

A survey of pediatric critical care nurses' knowledge of pain management

1997 ◽  
Vol 6 (4) ◽  
pp. 289-295 ◽  
Author(s):  
C Pederson ◽  
D Matthies ◽  
S McDonald
Keyword(s):  
Critical Care ◽  
Pain Management ◽  
Signs And Symptoms ◽  
Educational Interventions ◽  
Critical Care Nurses ◽  
Toxic Metabolite ◽  
Pediatric Critical Care ◽  
Related Information ◽  
Item Scale ◽  
Nurses Knowledge

BACKGROUND: Although nurses are accountable for pain management, it cannot be assumed that they are well informed about pain. Nurses' knowledge base underlies their pain management; therefore, it is important to measure their knowledge. OBJECTIVE: To measure pediatric critical care nurses' knowledge of pain management. METHOD: A descriptive, exploratory study was done. After a pilot study, an investigator-developed Pain Management Knowledge Test was distributed to 50 pediatric ICU nurses. Test responses were collected anonymously and coded by number. Item analysis was done, and descriptive statistics were calculated. Modified content analysis was used on requests for pain-related information. RESULTS: The test return rate was 38%. The overall mean score was 63%. Mean scores within test subsections varied from 50% to 92%. Other mean scores were 85% on a nine-item scale of drug-action items and 92% on a two-item scale of intervention items. However, no nurse recognized that cognitive-behavioral techniques can inhibit transmission of pain impulses; only 32% indicated that meperidine converts to a toxic metabolite, only 47% recognized nalbuphine as a drug that may cause signs and symptoms of withdrawal if given to a patient who has been receiving an opioid; and only 63% indicated that when a child states that the child has pain, pain exists. Thirteen nurses requested pain-related information, and all requests focused on analgesic medications. CONCLUSIONS: Testing nurses' knowledge of pain indicated gaps that can be addressed through educational interventions. Research is needed in which the test developed for this study is used as both pretest and posttest in an intervention study with pediatric critical care nurses or is modified for use with nurses in other clinical areas.

scholarly journals Implementation of the Critical Care Pain Observation Tool

2018 ◽  
Author(s):  
Carla Salvadore
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Critically Ill ◽  
Pain Assessment ◽  
The United States ◽  
Posttest Score ◽  
Assessment Instrument ◽  
Post Intervention ◽  
Nurses Knowledge

In the United States, greater than half of the adult patients who are admitted to critical care experience pain and report poor pain control. Inadequate management of acute pain is associated with negative outcomes, including high blood sugar, insulin resistance, higher infection risk, increased discomfort, decreased satisfaction, and chronic pain. Patients in the intensive care unit (ICU) cannot always express that they are having pain. Recently modified guidelines for the Sustained Use of Sedatives and Analgesics in the Critically Ill Adult recommend a reliable and valid pain assessment instrument for patients who are unable to verbalize pain. For the adult critically ill population, the Critical Care Pain Observation Tool (CPOT) and the Behavioral Pain Scale (BPS) were identified as the most reliable and valid instruments. The purpose of this program development was to provide education for nurses in the Cardiovascular Intensive Care Unit (CVICU) on the CPOT to assist in transitioning to the CPOT as part of the CVICU pain assessment. A pretest-posttest design was utilized to evaluate the nurses’ knowledge of the CPOT. The intervention consisted of a one-hour education session on pain assessment and the CPOT. Thirteen out of a potential twenty-two nurses (n=13, 59%) participated in the educational session with a mean pretest score of 42.3% and a mean posttest score of 93.1%. There was a 50.8% improvement post-intervention total scores. Findings from this quality improvement education intervention suggest that the CVICU nurses’ knowledge increased in both pain assessment and the CPOT following the intervention.

scholarly journals Impact of applying brief educational program on nurses knowledge, attitude, and practices toward pain management

2015 ◽  
Vol 4 (2) ◽  
pp. 164 ◽  
Author(s):  
Shalabia El-Sayead Abozead ◽  
Mahmoud Al-Kalaldeh ◽  
Omar Al-Tarawneh
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Educational Program ◽  
Pain Education ◽  
Knowledge And Attitudes ◽  
Post Test ◽  
Knowledge And Attitude ◽  
Nurses Knowledge

<p><strong>Background:</strong> The role of pain education is well established in improving knowledge and attitude towards the adherence to pain assessment and management.</p><p><strong>Methods:</strong> A brief pain education program was delivered to assess nurses' knowledge and attitude towards pain assessment and management. The "KASRP" scale was used at three phases; pre, post, and three months' follow-up phases. Subsequent eight months observation on using pain assessment sheets was also performed.</p><p><strong>Results:</strong> One hundred and four nurses were assessed at the beginning, followed by 92 at the immediate post-test, and 70 at the follow-up. Although nurses scored lowest in having knowledge and attitudes prior to the program, a significant improvement was evident after delivering pain education. In addition, nurses' competency in pain assessment was maintained over the three months of assessment. Younger nurses with shorter clinical experience were found more reactive to the program than older nurses.</p><p><strong>Conclusions:</strong> A brief nurse-driven pain education has improved nurses' knowledge and attitude towards pain management.</p>

Making It Meaningful: Finding Quality Improvement Projects Worthy of Your Time, Effort, and Expertise

2015 ◽  
Vol 35 (6) ◽  
pp. 57-61 ◽  
Author(s):  
Julie M. Stausmire ◽  
Charla Ulrich
Keyword(s):  
Critical Care ◽  
Quality Improvement ◽  
Health Care Providers ◽  
Physical Environment ◽  
Critical Care Nurses ◽  
Care Providers ◽  
Improvement Project ◽  
Specific Patient ◽  
Critical Care Units ◽  
Part Quality

This article is the second of a 4-part quality improvement resource series for critical care nurses interested in implementing system process or performance improvement projects. The article is a brainstorming session on paper, written to assist nurses and managers in identifying possible quality improvement projects that are meaningful to them and will make a real difference in their critical care units. Every unit and institution has its own unique mix of resources, culture, physical environment, patient population, technology, documentation processes, health care providers, and multiple other factors. Thus specific patient care and safety challenges must be identified and prioritized individually for quality improvement by each unit. Projects also must be manageable and within the scope of time, effort, and expertise available—no quality improvement project is “too small” if it is applicable to your critical care area and will improve outcomes.

scholarly journals Pain Assessment Using the Critical-Care Pain Observation Tool in Chinese Critically Ill Ventilated Adults

2014 ◽  
Vol 48 (5) ◽  
pp. 975-982 ◽  
Author(s):  
Qingdong Li ◽  
Xianyao Wan ◽  
Chunmei Gu ◽  
Yang Yu ◽  
Wei Huang ◽  
...  
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Pain Assessment
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