Pain
Conditions
Keywords
Pain management, Pain assessment, Intensive care unit, Adult
Brief summary
The purpose of this study is to evaluate the effect of an algorithm, where ICU patients pain are assessed systematically with valid pain assessment tools and where pain is treated after pain intensity score.
Detailed description
As a pre-test, before the intervention is introduced, data from ICU patients from four intensive care units (ICU) will be collected from medical records to evaluate current pain management practices. An algorithm, which is developed by a group of resource persons, is educated to the staff in three of the ICUs. The staff will also receive training and guiding in the use of the algorithm and the different pain assessment tools. Then the algorithm will be implemented and used in all the consecutive ICU patients. Post-test data is then collected in the three ICUs. In the fourth ICU, which will be used as a comparison unit, the same post-test data will be collected at the same time as data in intervention ICUs were collected. The algorithm will not be introduced here.
Interventions
OTHERPain management algorithm
The algorithm guide the clinicians to score ICU patients pain systematically with different pain assessment tools. The tools are the Numeric Rating Scale, Behavioral Pain Scale and Behavioral Pain Scale Non Intubated. The algorithm guide the clinicians to choose between the different pain assessment tools depending on the ICU patient's condition and ability to rate his own pain. Thereafter the algorithm guide the clinicians to treat pain depending on the pain intensity score.
Sponsors
Oslo University Hospital
Ostfold Hospital Trust
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All consecutive patients admitted into these four ICUs
Exclusion criteria
* Patients will be excluded if they are not able to express pain behaviors (i.e. quadriplegic, are receiving neuromuscular blockade or muscle paralyzing drugs or are being investigated for brain death.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Duration of mechanical ventilation, ICU and hospital length of stay | The participants will be followed for the duration of hospital stay, an expected average of two weeks | Duration of mechanical ventilation, ICU and hospital length of stay will be measured in a group of ICU patients before (pre-test) and after (post-test) the intervention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Documentation of ICU patients' pain and pain management in four ICU's. | The participants will be followed for the duration of ICU stay, an expected average of one week | The data is collected to evaluate current pain and pain management practices in a period before the intervention is implemented (pre-test). The data is collected from both intervention units and control unit. |
| Proportion of ICU patients express having pain or are estimated to have pain. How severe their pain is. | The participants will be followed for the duration of ICU stay, an expected average of one week | In the pre-test, the medical records are searched for use of different pain assessment tools or other notations about pain assessment of these patients. In the post-test the medical records are searched for systematically pain intensity scores from the different pain assessment tools. |
| The clinician's adherence to the pain management algorithm in ICU patients. | The adherence will be followed for the duration of ICU stay, an expected average of one week (post-test) | The medical records will be searched for documentation of how the algorithm is used. I.e. is it used to the right patients, Is it used as often as described, is it used to the right patients. |
| Sedation level and Use of psychoactive drugs | The participants will be followed for the duration of ICU stay, an expected average of one week | Sedation level and use of psychoactive drugs will be measured before (pre-test) and after (post-test) the intervention. |
| Use of Analgesics | The participants will be followed for the duration of ICU stay, an expected average of one week | Use of analgesics will be measured before (pre-test) and after (post-test) the intervention. |
Countries
Norway
Outcome results
None listed