Modanloo Mahnaz, Mohsenpour Afsaneh, Rahmani Hossein, Moghaddam Shahram, Khoddam Homeira
Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Critical Care Nursing, Nursing and Midwifery School, Golestan University of Medical Sciences, Gorgan, Iran.
Indian J Crit Care Med. 2019 Apr;23(4):165-169. doi: 10.5005/jp-journals-10071-23146.
Pain management is one of the most important responsibilities of nurses in an intensive care unit (ICU). It is difficult to perform pain assessment appropriately in patients who are unable to report their pain. This study is aimed to determine the impact of implementing the critical care pain observation tool (CPOT) on the amount and frequency of analgesics' administration in ICUs.
This interventional study was conducted in 2014. Sixty nurses and 240 patients were studied. This study was carried out in three phases: first the data about amount and frequency of analgesic administration were extracted from patients' medical files. Then the CPOT was implemented into the nursing assessment process and finally, nurses' performance regarding the amount and frequency of analgesic administration was recorded. This data obtained before and after intervention were analyzed using chi-square and independent t-test values less than 0.05 were considered significant.
In this interventional study, we found that there was no difference in the demography and cause of ICU admission before and after implementation of CPOT (age = 0.937, gender = 0.996, and the cause of admission = 0.996). We found that after implementing the CPOT into the nursing assessment process, the amount of analgesics administered (7.95 ± 8.77 mg vs. 11.01 ± 11.04 mg, = 0.018) and the frequency of administration (2.91 ± 1.38 vs. 4.16 ± 0.99, <0.001) increased significantly. Moreover, there was a significant increase in the frequency of pain assessment per patient per day in nursing practice after implementation of CPOT as compared to the practice before (7.2 ± 2.48 vs. 1.03 ± 1.63, <0.001). The mean pain scores before and after the intervention (5.5 ± 1.08 vs.2.2 ± 0.48) were also significantly different.
Applying CPOT, as an objective mean of pain assessment, was effective in improving the performance of ICU nurses in assessment and management of patients' pain. It increased the amount and frequency of analgesic administration. We can recommend that COPT is a useful tool for assessment and management of pain in ICU patients and should be implemented in all ICUs.
Modanloo M, Mohsenpour A, Impact of Implementing the Critical Care Pain Observation Tool on Nurses' Performance in Assessing and Managing Pain in the Critically Ill Patients. Indian J Crit Care Med 2019;23(4):165-169.
疼痛管理是重症监护病房（ICU）护士最重要的职责之一。对于无法报告自身疼痛的患者，进行适当的疼痛评估具有一定难度。本研究旨在确定实施重症监护疼痛观察工具（CPOT）对ICU中镇痛药使用量和使用频率的影响。
本干预性研究于2014年进行。共对60名护士和240名患者进行了研究。本研究分三个阶段进行：首先从患者病历中提取镇痛药使用量和使用频率的数据。然后将CPOT应用于护理评估过程，最后记录护士在镇痛药使用量和使用频率方面的表现。使用卡方检验和独立t检验对干预前后获得的数据进行分析，P值小于0.05被认为具有统计学意义。
在本干预性研究中，我们发现实施CPOT前后，ICU患者的人口统计学特征和入住ICU的原因没有差异（年龄P = 0.937，性别P = 0.996，入住原因P = 0.996）。我们发现，将CPOT应用于护理评估过程后，镇痛药的使用量（7.95±8.77mg对11.01±11.04mg，P = 0.018）和使用频率（2.91±1.38对4.16±0.99，P<0.001）均显著增加。此外，与实施CPOT前相比，实施CPOT后护理实践中每位患者每天的疼痛评估频率显著增加（7.2±2.48对1.03±1.63，P<0.001）。干预前后的平均疼痛评分（5.5±1.08对2.2±0.48）也有显著差异。
应用CPOT作为一种客观的疼痛评估方法，可有效提高ICU护士对患者疼痛的评估和管理能力。它增加了镇痛药的使用量和使用频率。我们建议CPOT是评估和管理ICU患者疼痛的有用工具，应在所有ICU中实施。
Modanloo M, Mohsenpour A, 实施重症监护疼痛观察工具对重症患者疼痛评估和管理中护士表现的影响。《印度重症监护医学杂志》2019；23(4):165 - 169。
