Intensive care nurses' assessment of pain in patients who are mechanically ventilated: How a pilot study helped to influence practice.

Background: Pain is a common experience among patients in intensive care units (ICUs). Many patients in ICUs have difficulty communicating their pain because of mechanical ventilation, and issues can arise when the nurse attempts to interpret the severity of pain,and work towards effective pain management.

Purpose: The aim of this study was to determine the suitability of the Critical-Care Pain Observation Tool (CPOT) as an assessment tool to be used by ICU nursing staff to assess pain in adult. patients who are mechanically ventilated.

Methods: This pilot study was descriptive in design and employed both quantitative and qualitative methods. Quantitative data resulted from the CPOT scores obtained. In addition, a data collection sheet, developed by the authors, recorded sedation and analgesia used and interventions provided. This separate sheet was completed each time the CPOT was used. Nurses were asked to evaluate the CPOT using a Likert scale. Qualitative data were collected through open-ended questions related to using the CPOT Results. Twenty-three participants each assessed pain five times in a total of 23 patients using the CPOT over a 12-hour shift. Nurses stated the tool was easy to use and that it would be helpful to them.

Conclusion: The results of this pilot study contributed to the decision to implement the CPOT at the study ICUs. The systematic use of a tool may promote more goal-directed management of pain.