Nurse-led Pain Management in Adult ICU; A Randomised Stepped-Wedge Hybrid Effectiveness Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Pain Management
- Sponsor
- King Abdulaziz Medical City
- Enrollment
- 880
- Locations
- 1
- Primary Endpoint
- Number of documented pain assessments per 24-hour period
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
This project is about implementing a pain scale, the Critical Care Pain Observation Tool (CPOT), in ICU settings at King Abdullah Medical City to evaluate its impact on nurse pain assessment and management.
Pain is considered as a significant problem in ICU and the literature shows that 50% of patients in ICU suffer moderate to severe pain and up to 70% of patients experience undetected pain while in ICU. The CPOT is an evidence-based intervention to assess pain among non-verbal patients in ICU settings. A stepped-Wedge Randomised trial will be used to implement the CPOT in 8 ICU in King Abduullah Medical City. Patient chart audits and a survey of ICU nurses will be conducted post implementation.
Detailed Description
This project is about implementing a pain scale, Critical Care Pain Observation Tool (CPOT), in 8 adult ICUs in King Abdullah Medical City to evaluate the impact on nurse pain assessment and management. The literature shows that pain is perceived to be one of the most concerning issues in ICU and that 50% of patients in the ICU suffer moderate to severe pain. In addition, 70% of patients have undetected pain while admitted to ICU. Evidence-based guidelines suggest that CPOT is the most reliable and efficient pain scale tool for non-verbal patients in ICUs, and it is recommended in countries such as the USA, Canada, Australia and New Zealand. The literature suggests that CPOT has a positive impact on frequency of pain assessment. A Stepped-Wedge Randomised trial will be used to implement the CPOT and at the same time assess the effectiveness of CPOT on pain assessment frequency and management. Patient charts will be audited, and a survey of nurses will be undertaken post CPOT implementation to assess the CPOT acceptability, appropriateness and feasibility.
Investigators
Majid Alotni
PhD student
Newcastle University
Eligibility Criteria
Inclusion Criteria
- •Patient's who are 18 years and above
- •Patients must be discharged from ICU
- •Exclusion criteria:
- •Patient's who are on muscle relaxants
- •Nurses survey
- •Inclusion criteria
- •Working in ICU
- •Understand English language
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Number of documented pain assessments per 24-hour period
Time Frame: 6 months
How many times pain is documented and reassessed then charted in the medical file for a non-verbal patient over a 24 hour period.
Secondary Outcomes
- Level of sedation and analgesia(6 months)
- Length of intubation (LOI)(6 months)
- Appropriateness(6 months)
- ICU stay(6 months)
- Acceptability(6 months)
- Feasibility in nursing practice(6 months)