Intensive and Postoperative Unit, Østfold Hospital Trust, Grålum, Norway; Faculty of Health and Welfare, Østfold University College, Halden, Norway.
Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
Pain Manag Nurs. 2020 Dec;21(6):543-548. doi: 10.1016/j.pmn.2020.05.006. Epub 2020 Jul 7.
Many patients have memories of pain during intensive care unit stay. To improve pain management, practice guidelines recommend that pain management should be guided by routine pain assessment and suggest an assessment-driven, protocol-based, stepwise approach. This recommendation prompted the development of a pain-management algorithm.
Evaluate the feasibility and clinical utility of this algorithm.
A descriptive survey.
One medical/surgical intensive care unit, one surgical intensive care unit, and one postanesthesia care unit at two hospitals in Norway.
PARTICIPANTS/SUBJECTS: Nurses working at the three units.
A pain-management algorithm, including three pain assessment tools and a guide to pain assessment and pain management, was developed and implemented in three intensive care units. Nurses working at the three units (n = 129) responded to a questionnaire regarding the feasibility and clinical utility of the algorithm used.
Our results suggested that nurses considered the new pain-management algorithm to have relatively high feasibility, but somewhat lower clinical utility. Less than half of respondents thought that pain treatment in clinical practice had become more targeted using the tree pain-assessment tools (45%) and the algorithm for pain assessment and pain management (24%).
Pain-management algorithms may be appropriate and useful in clinical practice. However, to increase clinical utility and to achieve more targeted pain treatment, more focus on pain-treatment actions and reassessment of patients' pain is needed. Further focus in clinical practice on how to implement an algorithm and more focus on pain-treatment action and reassessment of patients' pain is needed.
许多患者在重症监护病房住院期间都有疼痛记忆。为了改善疼痛管理，实践指南建议疼痛管理应根据常规疼痛评估进行指导，并建议采用评估驱动、基于方案、逐步递进的方法。这一建议促使了疼痛管理算法的开发。
评估该算法的可行性和临床实用性。
描述性调查。
挪威两家医院的一个内科/外科重症监护病房、一个外科重症监护病房和一个麻醉后护理病房。
参与者/受试者：三个单位的护士。
开发并实施了一种疼痛管理算法，其中包括三种疼痛评估工具以及疼痛评估和疼痛管理指南。在三个重症监护病房工作的护士（n=129）对该算法的可行性和临床实用性进行了问卷调查。
我们的结果表明，护士认为新的疼痛管理算法具有较高的可行性，但临床实用性略低。不到一半的受访者认为，在临床实践中，使用树状疼痛评估工具（45%）和疼痛评估及管理算法（24%）使疼痛治疗更有针对性。
疼痛管理算法在临床实践中可能是合适且有用的。然而，为了提高临床实用性，实现更有针对性的疼痛治疗，需要更加关注疼痛治疗措施，并重新评估患者的疼痛。在临床实践中，需要进一步关注如何实施算法，以及更加关注疼痛治疗措施和重新评估患者的疼痛。
