Document Detail


Implementation of the critical-care pain observation tool on pain assessment/management nursing practices in an intensive care unit with nonverbal critically ill adults: a before and after study.
MedLine Citation:
PMID:  21550048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Critical-Care Pain Observation Tool (CPOT) is one of the few behavioural pain scales which have been developed and validated for the purpose of detecting pain in nonverbal critically ill adults.
OBJECTIVES: This study aimed to complete a pre and post evaluation of the implementation of the CPOT on pain assessment/management nursing practices in the Intensive Care Unit (ICU) with nonverbal critically ill adults.
DESIGN: A before-and-after study design was used. Setting/Participants: The Intensive Care Unit (ICU) of a university affiliated health care centre in Montérégie (Canada) was selected for the implementation of the CPOT. All ICU nurses were trained to use the CPOT. Medical files were selected if the patient was 18 years or older, had been mechanically ventilated for a period ≥ 24hours, was unable to communicate, and had intact motor function.
METHODS: This implementation study included three steps: 1) pre-implementation phase, 2) implementation phase, and 3) post-implementation phase. The pre-implementation phase included the review of 30 medical files to describe the current nursing practice in pain assessment and management prior to the introduction of the CPOT. During the implementation phase, 60 ICU nurses attended standardized training sessions on the use of the CPOT and practiced the scoring with the CPOT using patients' videotapes. In the post-implementation phase, the interrater reliability of ICU nurses when using the CPOT was tested using three patients' videotapes. Also, pain assessment and management nursing practices were evaluated by reviewing 30 medical files at 3 months, and 30 others at 12 months post-implementation.
RESULTS: Nurses' percentage of agreement when scoring patients with the CPOT by viewing the videotapes was high post-implementation of the tool (>87%). Reports of pain assessments were more frequently charted in the medical files in the post-implementation phase (10.5 to 12 assessments in a 24-hour period) compared with the pre-implementation phase (3 assessments in a 24-hour period). Interestingly, fewer analgesic and sedative agents were administered during the post-implementation phase.
CONCLUSIONS: The CPOT was successfully implemented and seemed to have positive effects on pain assessment and management nursing practices in the ICU. Further research is warranted to look at its impact on patient outcomes.
Authors:
Céline Gélinas; Caroline Arbour; Cécile Michaud; Francine Vaillant; Sylvie Desjardins
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-05-06
Journal Detail:
Title:  International journal of nursing studies     Volume:  48     ISSN:  1873-491X     ISO Abbreviation:  Int J Nurs Stud     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-23     Completed Date:  2012-03-13     Revised Date:  2013-03-28    
Medline Journal Info:
Nlm Unique ID:  0400675     Medline TA:  Int J Nurs Stud     Country:  England    
Other Details:
Languages:  eng     Pagination:  1495-504     Citation Subset:  IM; N    
Copyright Information:
2011. Published by Elsevier Ltd.
Affiliation:
School of Nursing, McGill University, Montreal, Quebec, Canada. celine.gelinas@mcgill.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Critical Care*
Critical Illness*
Female
Humans
Intensive Care Units*
Male
Middle Aged
Nursing*
Pain Measurement*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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