Authors (including presenting author) :
LI HF(1), TANG NC(1), WONG YT(1)
Affiliation :
(1)Intensive Care Unit, Princess Margaret Hospital
Introduction :
Critically ill patients experience significant level of pain and discomfort from multiple intrinsic and extrinsic source while in ICU. However, the assessment of their pain is difficult since they are usually unable to self-report. To assess these patients' pain, it is important to use a valid and reliable pain assessment tool.
Objectives :
1) To identify the most appropriate pain assessment tool for patients unable to self-report in ICU. 2) To evaluate the compliance and the appropriateness of use of the identified pain assessment tool after its implementation.
Methodology :
1) Through literature review, two most recommended pain assessment tools for patient unable to self-report, i.e. Critical-care Pain Observation Tool (CPOT) and Behavioral Pain Scale (BPS), were identified and were chosen for further studies. PICO was employed as the structure to guide the direction of literature search. PRISMA flow diagram was used for articles screening. Finally, 10 articles were selected for in-depth analysis. Then a comparison of their psychometric properties (validity and reliability) was done. 2) A retrospective documentation review over a six months' period (totally 12 days) was done.
Result & Outcome :
1)For validity, CPOT and PBS are equally supported in terms of their criterion validity and discriminant validity. For reliability, CPOT is slightly preferable than BPS in terms of their inter-rater reliability and internal consistency. Further comparison was done for their clinical use. It was found that CPOT is more appropriate for the daily operational use in ICU. To conclude, CPOT is the most appropriate pain assessment tool for patient unable to self-report in ICU. 2)Total number of patient days evaluated was 151 days. The overall pain assessment compliance rate was 95%. The overall appropriateness of pain assessment tool used(within the compliance) was 92%
