Asadi-Noghabi Ahmad-Ali, Gholizadeh Mohammad, Zolfaghari Mitra, Mehran Abbas, Sohrabi Maryam
Department of Intensive Care Nursing, Tehran University of Medical Sciences, Tehran, Iran.
Department of Intensive Care Nursing, Bobol University of Medical Science, Babol, Iran.
Oman Med J. 2015 Jul;30(4):276-82. doi: 10.5001/omj.2015.55.
The diagnosis of pain in patients with low consciousness is a major challenge in the intensive care unit (ICU). Therefore, the use of behavioral tools for pain assessment could be an effective tool to manage pain in this group of patients. The aim of this study was to determine the effects on pain management by nurses using a critical care pain observational tool in patients with a decreased level of consciousness. .
Our research used a before and after design to evaluate the ability of nurses to manage pain in patients with low consciousness. A total of 106 ICU nurses were included in the study. The study was divided into three phases: pre-implementation, implementation, and post-implementation. The researchers first observed the nurses management of pain in their patients; this was done three times using a checklist following tracheal suctioning and position change procedures. The nurses were then taught how to apply the critical-care pain observational tool (CPOT). Post-implementation of the tool, the researchers re-evaluated trained the nurses' pain management. .
Performance scores after training improved with relation to the nurses diagnosis of pain, pharmacological and nonpharmacological actions, reassessment of pain, and re-relieving of any pain. However, use of the tool did not improve the recording of the patient's pain and the relief measures used. .
Use of the CPOT can increase nurse's sensitivity to pain in non-conscious patients and drive them to track and perform pain management.
对意识不清患者的疼痛进行诊断是重症监护病房（ICU）面临的一项重大挑战。因此，使用行为学工具进行疼痛评估可能是管理这类患者疼痛的有效方法。本研究的目的是确定护士使用重症监护疼痛观察工具对意识水平下降患者疼痛管理的效果。
我们的研究采用前后对照设计，以评估护士对意识不清患者疼痛的管理能力。共有106名ICU护士纳入本研究。研究分为三个阶段：实施前、实施和实施后。研究人员首先观察护士对患者疼痛的管理情况；在气管吸痰和更换体位操作后，使用检查表进行了三次观察。然后教护士如何应用重症监护疼痛观察工具（CPOT）。在工具实施后，研究人员重新评估了护士的疼痛管理情况。
培训后的绩效得分在护士对疼痛的诊断、药物和非药物措施、疼痛重新评估以及再次缓解任何疼痛方面有所提高。然而，该工具的使用并未改善对患者疼痛的记录以及所采用的缓解措施。
使用CPOT可以提高护士对无意识患者疼痛的敏感度，并促使他们跟踪和进行疼痛管理。
