Behavioral pain assessment tool for critically ill adults unable to self-report pain
Critically ill adults often cannot self-report pain. To determine the effect of the Critical-Care Pain Observation Tool on frequency of documentation of pain assessment and administration of analgesics and sedatives in critically ill patients unable to self-report pain. Data on patients in 2 intensi...
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| Veröffentlicht in: | American journal of critical care 2013-05, Vol.22 (3), p.246-255 |
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| container_title | American journal of critical care |
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| creator | Rose, Louise Haslam, Lynn Dale, Craig Knechtel, Leasa McGillion, Michael |
| description | Critically ill adults often cannot self-report pain.
To determine the effect of the Critical-Care Pain Observation Tool on frequency of documentation of pain assessment and administration of analgesics and sedatives in critically ill patients unable to self-report pain.
Data on patients in 2 intensive care units of a university-affiliated hospital were collected before and after implementation of the tool. Patients were prospectively screened for eligibility; data were extracted retrospectively.
Data were recorded for a maximum of 72 hours before and after implementation of the tool in the cardiovascular intensive care unit (130 patients before and 132 after) and in the medical/surgical/trauma unit (59 patients before and 52 after). Proportion of pain assessment intervals with pain assessment documented increased from 15% to 64% (P < .001) in the cardiovascular unit and from 22% to 80% (P < .001) in the other unit. Median total dose of opioid analgesics decreased from 5 mg to 4 mg in the cardiovascular unit (P = .02) and increased from 27 mg to 75 mg (P = .002) in the other unit. Median total dose of benzodiazepines decreased from 12 mg to 2 mg (P < .001) in the cardiovascular unit and remained unchanged in the other unit. Increased documentation of pain assessment was associated with increased age in the cardiovascular unit and with decreased maximum scores on the Sequential Organ Failure Assessment in the other unit.
Implementation of the tool increased frequency of pain assessment and appeared to influence administration of analgesics in both units. |
| doi_str_mv | 10.4037/ajcc2013200 |
| format | Article |
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To determine the effect of the Critical-Care Pain Observation Tool on frequency of documentation of pain assessment and administration of analgesics and sedatives in critically ill patients unable to self-report pain.
Data on patients in 2 intensive care units of a university-affiliated hospital were collected before and after implementation of the tool. Patients were prospectively screened for eligibility; data were extracted retrospectively.
Data were recorded for a maximum of 72 hours before and after implementation of the tool in the cardiovascular intensive care unit (130 patients before and 132 after) and in the medical/surgical/trauma unit (59 patients before and 52 after). Proportion of pain assessment intervals with pain assessment documented increased from 15% to 64% (P < .001) in the cardiovascular unit and from 22% to 80% (P < .001) in the other unit. Median total dose of opioid analgesics decreased from 5 mg to 4 mg in the cardiovascular unit (P = .02) and increased from 27 mg to 75 mg (P = .002) in the other unit. Median total dose of benzodiazepines decreased from 12 mg to 2 mg (P < .001) in the cardiovascular unit and remained unchanged in the other unit. Increased documentation of pain assessment was associated with increased age in the cardiovascular unit and with decreased maximum scores on the Sequential Organ Failure Assessment in the other unit.
Implementation of the tool increased frequency of pain assessment and appeared to influence administration of analgesics in both units.</description><identifier>ISSN: 1062-3264</identifier><identifier>EISSN: 1937-710X</identifier><identifier>DOI: 10.4037/ajcc2013200</identifier><identifier>PMID: 23635934</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Aged ; Analgesics - administration & dosage ; Analgesics - therapeutic use ; Critical Illness ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Multivariate Analysis ; Nursing ; Pain Management - methods ; Pain Management - nursing ; Pain Measurement - methods ; Pain Measurement - nursing ; Prospective Studies</subject><ispartof>American journal of critical care, 2013-05, Vol.22 (3), p.246-255</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-377d0922c7a8be6a96708ad16cf13a9a0ec6b90c9cedea484a7eb0f6397b78ae3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23635934$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rose, Louise</creatorcontrib><creatorcontrib>Haslam, Lynn</creatorcontrib><creatorcontrib>Dale, Craig</creatorcontrib><creatorcontrib>Knechtel, Leasa</creatorcontrib><creatorcontrib>McGillion, Michael</creatorcontrib><title>Behavioral pain assessment tool for critically ill adults unable to self-report pain</title><title>American journal of critical care</title><addtitle>Am J Crit Care</addtitle><description>Critically ill adults often cannot self-report pain.
To determine the effect of the Critical-Care Pain Observation Tool on frequency of documentation of pain assessment and administration of analgesics and sedatives in critically ill patients unable to self-report pain.
Data on patients in 2 intensive care units of a university-affiliated hospital were collected before and after implementation of the tool. Patients were prospectively screened for eligibility; data were extracted retrospectively.
Data were recorded for a maximum of 72 hours before and after implementation of the tool in the cardiovascular intensive care unit (130 patients before and 132 after) and in the medical/surgical/trauma unit (59 patients before and 52 after). Proportion of pain assessment intervals with pain assessment documented increased from 15% to 64% (P < .001) in the cardiovascular unit and from 22% to 80% (P < .001) in the other unit. Median total dose of opioid analgesics decreased from 5 mg to 4 mg in the cardiovascular unit (P = .02) and increased from 27 mg to 75 mg (P = .002) in the other unit. Median total dose of benzodiazepines decreased from 12 mg to 2 mg (P < .001) in the cardiovascular unit and remained unchanged in the other unit. Increased documentation of pain assessment was associated with increased age in the cardiovascular unit and with decreased maximum scores on the Sequential Organ Failure Assessment in the other unit.
Implementation of the tool increased frequency of pain assessment and appeared to influence administration of analgesics in both units.</description><subject>Adult</subject><subject>Aged</subject><subject>Analgesics - administration & dosage</subject><subject>Analgesics - therapeutic use</subject><subject>Critical Illness</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Nursing</subject><subject>Pain Management - methods</subject><subject>Pain Management - nursing</subject><subject>Pain Measurement - methods</subject><subject>Pain Measurement - nursing</subject><subject>Prospective Studies</subject><issn>1062-3264</issn><issn>1937-710X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkM1LxDAQR4Mo7rp68i45ClKdNN2kOeriFyx4WcFbmaZT7JI2a9IK-99bdRWPnmYOj_eDx9ipgMsMpL7CtbUpCJkC7LGpMFInWsDL_viDShOZqmzCjmJcA4gs1_qQTVKp5NzIbMpWN_SK740P6PgGm45jjBRjS13Pe-8dr33gNjR9Y9G5LW-c41gNro986LB0NFI8kquTQBsf-i_JMTuo0UU62d0Ze767XS0ekuXT_ePiepnYcb1PpNYVmDS1GvOSFBqlIcdKKFsLiQaBrCoNWGOpIszyDDWVUCtpdKlzJDlj59_eTfBvA8W-aJtoyTnsyA-xEFLpXCuT6f-gc5MLJWBEL75RG3yMgepiE5oWw7YQUHwWL_4UH-mznXgoW6p-2Z_E8gPG-nzR</recordid><startdate>201305</startdate><enddate>201305</enddate><creator>Rose, Louise</creator><creator>Haslam, Lynn</creator><creator>Dale, Craig</creator><creator>Knechtel, Leasa</creator><creator>McGillion, Michael</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>7X8</scope></search><sort><creationdate>201305</creationdate><title>Behavioral pain assessment tool for critically ill adults unable to self-report pain</title><author>Rose, Louise ; Haslam, Lynn ; Dale, Craig ; Knechtel, Leasa ; McGillion, Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-377d0922c7a8be6a96708ad16cf13a9a0ec6b90c9cedea484a7eb0f6397b78ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analgesics - administration & dosage</topic><topic>Analgesics - therapeutic use</topic><topic>Critical Illness</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Nursing</topic><topic>Pain Management - methods</topic><topic>Pain Management - nursing</topic><topic>Pain Measurement - methods</topic><topic>Pain Measurement - nursing</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rose, Louise</creatorcontrib><creatorcontrib>Haslam, Lynn</creatorcontrib><creatorcontrib>Dale, Craig</creatorcontrib><creatorcontrib>Knechtel, Leasa</creatorcontrib><creatorcontrib>McGillion, Michael</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rose, Louise</au><au>Haslam, Lynn</au><au>Dale, Craig</au><au>Knechtel, Leasa</au><au>McGillion, Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Behavioral pain assessment tool for critically ill adults unable to self-report pain</atitle><jtitle>American journal of critical care</jtitle><addtitle>Am J Crit Care</addtitle><date>2013-05</date><risdate>2013</risdate><volume>22</volume><issue>3</issue><spage>246</spage><epage>255</epage><pages>246-255</pages><issn>1062-3264</issn><eissn>1937-710X</eissn><abstract>Critically ill adults often cannot self-report pain.
To determine the effect of the Critical-Care Pain Observation Tool on frequency of documentation of pain assessment and administration of analgesics and sedatives in critically ill patients unable to self-report pain.
Data on patients in 2 intensive care units of a university-affiliated hospital were collected before and after implementation of the tool. Patients were prospectively screened for eligibility; data were extracted retrospectively.
Data were recorded for a maximum of 72 hours before and after implementation of the tool in the cardiovascular intensive care unit (130 patients before and 132 after) and in the medical/surgical/trauma unit (59 patients before and 52 after). Proportion of pain assessment intervals with pain assessment documented increased from 15% to 64% (P < .001) in the cardiovascular unit and from 22% to 80% (P < .001) in the other unit. Median total dose of opioid analgesics decreased from 5 mg to 4 mg in the cardiovascular unit (P = .02) and increased from 27 mg to 75 mg (P = .002) in the other unit. Median total dose of benzodiazepines decreased from 12 mg to 2 mg (P < .001) in the cardiovascular unit and remained unchanged in the other unit. Increased documentation of pain assessment was associated with increased age in the cardiovascular unit and with decreased maximum scores on the Sequential Organ Failure Assessment in the other unit.
Implementation of the tool increased frequency of pain assessment and appeared to influence administration of analgesics in both units.</abstract><cop>United States</cop><pmid>23635934</pmid><doi>10.4037/ajcc2013200</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | American journal of critical care, 2013-05, Vol.22 (3), p.246-255 |
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| language | eng |
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| subjects | Adult Aged Analgesics - administration & dosage Analgesics - therapeutic use Critical Illness Female Humans Intensive Care Units Male Middle Aged Multivariate Analysis Nursing Pain Management - methods Pain Management - nursing Pain Measurement - methods Pain Measurement - nursing Prospective Studies |
| title | Behavioral pain assessment tool for critically ill adults unable to self-report pain |
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