Pain assessment in the critically ill ventilated adult: Validation of the critical-care pain observation tool and physiologic indicators

Behavioral Pain Assessment Tool for Critically Ill Adults Unable to Self-Report Pain

“…The overall validity. 7,16,17 Before implementation of the CPOT, the pain management policies of the ICUs did not include use of a behavioral pain assessment tool, although individual nurses self-reported that they used various tools, including the CPOT. 18 The recommended frequency of pain assessment, or pain assessment intervals (PAIs), for surgical patients was hourly for 6 hours postoperatively and then a minimum of every 4 hours.…”

Observational Pain Scales in Critically Ill Adults

“…A cross-over observational design was used to test the first English version of the CPOT in a group of 30 conscious and 25 unconscious general ICU patients. 37 Additional data were collected in this study, 37 including physiological data and patients' self-report of pain via use of the Faces Pain Thermometer. Interrater reliability was acceptable (intraclass correlation coefficients, 0.80-0.93) among the 51 nurses who collected the data.…”

Towards a Standardized Approach for Critical Care Nursing Practices: Development of Evidence Based Analgo-Sedation Guidelines for Adult Mechanically Ventilated Patients

“…Their regular use can lead to better pain management and improved clinical outcomes in ICU patients. In addition two descriptive studies (Level of evidence 1+) [30,43] provide consistent evidence that the BPS and CPOT scales have good psychometric properties in terms of inter-rater reliability and discriminant validity in ICU patients.…”

“…The interrater reliability of CPOT was assessed by Gélinas and Johnson (2007) and found to be 0.80-0.93. [30] Also, the AGREE II tool has been tested for reliability and validity, and is applicable to a wide variety of health professionals. [31] …”

“…According to three descriptive studies (Level of evidence 2++) [30,43,44] , and one analgesia/sedation guidelines [39] , it was recommended that vital signs should not be used alone for pain assessment in adult ICU patients. Vital signs may be used as a cue to begin further pain assessment (Recommendation number 1.3 Box 6).…”