Nurses' Assessment Practices of Pain Among Critically Ill Patients

Nurses’ Perceived Barriers to and Facilitators of Pain Assessment and Management in Critical Care Patients: A Systematic Review

“… 22 In addition to the abovementioned clinical settings, the majority of the studies also included other settings, such as medical-surgical units, medical units, and burn units. 21 , 27 Only Wang and Tsai 20 and Asman et al 17 were conducted in medical centers.…”

“… VI Khalil, 29 Egypt Descriptive exploratory To evaluate the use of nonpharmacological management for pain control among ICU nurses 100% 60 ICU nurses Nonpharmacological pain management checklist A substantial proportion of critical care nurses did not use nonpharmacological intervention practices to control their patients’ pain. VI Hamdan, 27 Jordan Descriptive cross-sectional To evaluate critical care nurses’ pain assessment practices. 60.1% 300 ICU nurses The Pain Assessment and Management for the Critically Ill survey The most valid and reliable tools for both verbal and nonverbal patients were not often used by nurses, and nurses were not aware of most behavioral pain indicators among critically ill patients.…”

Use of PADIS Assessment Tools by Critical Care Nurses: An Integrative Review

“…Perceived importance of pain assessment and frequency for patients unable to self-report (Hamdan, 2019) were significantly correlated (r 2 (298) = 0.42, p < 0.01). Nurses also believed use of the RASS tool balanced well with conducting other assessments (Hetland et al, 2018).…”

“…Nurses use of the CAM-ICU improved organization of assessment (Scott et al, 2013) and improved patient outcomes (Oosterhouse et al, 2016). Use of the CAM-ICU also facilitated recognition of hypoactive delirium (Jung et al, 2013;Schaef, 2019) and distinguished between other causes of restlessness (Zamoscik (Bourbonnais et al, 2016); positive correlation between perceived importance and use (Hamdan, 2019) (−) physiological parameters interpreted as pain episode (Alikiaie et al, 2019;Gerber et al, 2015); prefers own clinical judgement (Deldar et al, 2018;Mascarenhas et al, 2018); does not believe result; belief that tool is not necessary if sedated/given analgesics; belief that unconscious patients feel no pain; unfamiliar with tool (Deldar et al, 2018); consider nurses' opinion as gold standard (Van Der Woude et al, 2016); used tool more in patients able to report than unable to report (Hamdan, 2019); knowledge of behaviors indicating pain was negatively correlated with perceived adequacy of departmental pain treatment (r = −0.19, p < 0.05) (Asman et al, 2019) Agitation (+) awareness of paradigm shift to "awake and comfortable" (Egerod et al, 2013); tool use balanced with other assessments (Hetland et al, 2018) Delirium (+) tool use increased awareness of delirium (Jung et al, 2013); tool use supplemented other assessments (LeBlanc et al, 2018); patient-centered care; perception of delirium as a problem (Özsaban & Acaroglu, 2016); retained knowledge after education intervention (Smith et al, 2017); understood how to use (Swan, 2014); belief that delirium is important to assess (Powell et al, 2019) (−) mechanically ventilated patients (Andrews et al, 2015;Özsaban & Acaroglu, 2016;Rowley-Conwy, 2017;Scott et al, 2013); prefers own clinical judgement (Christensen, 2014;Steinseth et al, 2018;Zamoscik et al, 2017); question accuracy ...…”

“…Several studies highlighted how false beliefs about pain assessment that prevented tool use (Alikiaie et al, 2019;Deldar et al, 2018;Gerber et al, 2015;Hamdan, 2019). Nurses did not believe the results of the tool and preferred their own clinical judgement over the tools to assess the patients for both delirium and pain (Christensen, 2014;Deldar et al, 2018;Mascarenhas et al, 2018;Steinseth et al, 2018;Van Der Woude et al, 2016;Zamoscik et al, 2017).…”