Evaluation of the Feasibility and Clinical Utility of the Use of the Critical Care Pain Observation Tool among Mechanically Ventilated Neuro-critical Ill Patients
Keywords:Feasibility, Clinical utility, CPOT, Mechanically ventilated, Neuro-critical ill patients
Background: Critical-Care Pain Observation Tool (CPOT) was used for pain assessment in critical ill patients who are unable to communicate but CPOT was not frequently observed in neuro-critical ill patients that express unique behaviors.Objective: We aimed to evaluate the feasibility and clinical utility of the use of the critical care pain observation tool (CPOT) among mechanically ventilated neuro-critical ill patients.Method: A descriptive study was conducted in Chiang Mai neurological hospital. Thirty-seven doctors and nurses who worked in ICU-neuro were invited to complete the self-administered questionnaire on the CPOT feasibility and clinical utility. The tool indicators were evaluated separately.Result: Twenty-nine of the ICU-neuro staffs completed the questionnaire.
Feasibility: Most of the participants agreed that the tool contents were clear, quick to use, simple to understand and easy to complete (54-63%). Clinical utility: The tool was found useful by most staffs, they agreed that the tool was not interfere work and policy, helpful the practice and decision, easy to communicate and beneficial their practice (55-83%), but few of them agreed that the tool indicators could reflect the intensity of pain in all patients (39-46%)Conclusion: The CPOT was found to be feasible and useful in mechanically ventilated neuro-critical ill patients, but the tool indicators not reflected to the intensity of pain in some patients.
Rangel-Castilla L, Gopinath S, Robertson CS. Management of intracranial hypertension. Neurol Clin 2008;26:521–41.
Gordon DB, Dahl JL, Miaskowski C, McCarberg B, Todd KH, Paice JA, et al. American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force. Arch Intern Med 2005;165:1574-80.
Payen JF, Bosson JL, Chanques G, Mantz J, Labarere J. Pain assessment is associated with decreased duration of mechanical ventilation in the intensive care unit: a post Hoc analysis of the DOLOREA study. Anesthesiology 2009;111:1308-16.
Hamill-Ruth RJ, Marohn ML. Evaluation of pain in the critically ill patient. Crit Care Clin 1999; 15:35-54.
Kwekkeboom KL, Herr K. Assessment of pain in the critically ill. Crit Care Nurs Clin North Am 2001;13:181-94.
Azzam PN, Alam A. Pain in the ICU: a psychiatric perspective. J Intensive Care Med 2013;28:140-50.
Jean-Francois P, Olivier B, Jean-Luc B, Anna L, Eric N, Isabelle D, et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med 2001;29:2258-63
Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care 2006; 15:420–7.
Gélinas C, Harel F, Fillion L, Puntillo KA, Johnston CC. Sensitivity and specificity of the critical-care pain observation tool for the detection of pain in intubated adults after cardiac surgery. J Pain Symptom Manage 2009;37:58-67.
Nurnberg Damstrom D, Saboonchi F, Sackey PV, Bjorling G. A preliminary validation of the Swedish version of the critical-care pain observation tool in adults. Acta Anaesthesiol Scand 2011;55:379-86
Stilma W, Rijkenberg S, Feijen HM, Maaskant JM, Endeman H. Validation of the Dutch version of the critical - care pain observation tool. Nurs Crit Care 2019;24:132-40
Emsden C, Schafer UB, Denhaerync K, Grossman F, Frei IA, Kirsch M. Validating a pain assessment tool in heterogenous ICU patients: is it possible. Nurs Crit Care 2020;25:8-15.
Wongtangman K, Chaiwat O, Suraseranivongse S, Thikom N, Sanansilp V, Wangnamthip S. Validation of the Thai version critical care pain observation tool and behavioral pain scale in postoperative mechanically ventilated ICU patients. J Med Assoc Thai 2017;100:9-16.
Gélinas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the critical-care pain observation tool and physiologic indicators. Clin J Pain 2007;23:497-505.
Devlin J, Skrobik Y, Gélinas C, Needham D, Slooter A, Pandharipande P, et al. Executive summary: clinical practice guidelines for the prevention and management of pain, Agitation/Sedation, Delirium, Immobility, and sleep disruption in adult patients in the ICU. Crit Care Med 2018;46:1532-48.
Roulin MJ, Ramelet AS. Behavioral changes in brain-injured critical care adults with different levels of consciousness during nociceptive stimulation: an observational study. Intensive Care Med 2014;40:1115-23.
Gélinas C, Boitor M, Puntillo KA, Arbour C, Topolovec-Vranic J. Cusimano MD, et al. Behaviors indicative of pain in braininjured adult patients with different levels of consciousness in the intensive care unit. J Pain Symptom Manage. 2018; 57:761-73.
Gélinas C. Nurses’ evaluations of the feasibility and the clinical utility of the critical-care pain observation tool. Pain Manag Nurs 2010;11:115-25.
Maatouk H, Al Tassi A, Fawaz MA, Itani MS. Nurses’ evaluation of critical care pain observation tool (CPOT) implementation for mechanically ventilated intensive care patients. Data Brief 2019;25:103997.
Arbour C, Choinière M, Topolovec-Vranic J, Loiselle C, Puntillo K, GélinasC. Detecting pain in traumatic brain-injured patients with different levels of consciousness during common procedures in the ICU: typical or atypical behaviors? Clin J Pain 2014;30:960-9
Joffe AM, Mc Nulty B, Boitor M, Marsh R, Gélinas C. Validation of the critical-care pain observation tool in brain-injured critically ill adults. J Crit Care 2016;36:76-80.
Richard-Lalonde M, Bérubé M, Williams V, Bernard F, Tsoller D, Gélinas C. Nurses’ evaluations of the feasibility and clinical utility of the use of the critical-care pain observation tool-Neuro in critically ill brain-injured patients. Science of Nursing and Health practices 2019;2:2.
Gélinas C, Bérubé M, Puntillo KA, Boitor M, Richard-Lalonde M, Bernard F, et al. Validation of the critical-care pain observation tool-neuro in brain-injured adults in the intensive care unit: a prospective cohort study. Crit Care 2021;25:142.
Heale R, Twycross A. Validity and reliability in quantitative studies. Evid Based Nurs 2015;18:66-67.
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