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Introduction: The aim of this study was to explore the use of a multi-parameter technology, the Nociception Level (NOL) index (Medasense Biometrics Ltd, Ramat Gan, Israel), for pain assessment in postoperative awake patients after cardiac surgery during non-nociceptive and nociceptive procedures in the intensive care unit (ICU). Materials and Methods: A prospective cohort repeated-measures design was used. Patients were included if they were in the ICU after undergoing cardiac surgery and if they could self-report their pain. A non-invasive probe was placed on the patient's finger for the continuous monitoring of the NOL index. Patients' self-reports of pain and anxiety (0– 10 Numeric Rating Scale or NRS), and behavioral scores with the Critical-Care Pain Observation Tool (CPOT) were obtained before and during a non-nociceptive procedure (ie, non-invasive blood pressure [NIBP] using cuff inflation), and before, during and after a nociceptive procedure (ie, chest tube removal [CTR]) for a total of five time points. Non-parametric tests were used to compare scores at different time points, and receiver operating characteristic curve analysis was performed. Results: Fifty-four patients were included in the analysis. The NOL index, pain and anxiety scores were significantly higher during CTR compared to rest and NIBP (p < 0.001). During CTR, the NOL was associated with self-reported pain intensity and unpleasantness but not with anxiety and CPOT scores. The NOL showed a modest performance in detecting pain (NRS ≥ 1 and ≥ 5) in this sample with sensitivity and specificity ranging from 61% to 85%. Conclusion: The NOL index was able to discriminate between a non-nociceptive and a nociceptive procedure and was associated with self-reported pain. Further validation testing of the NOL is necessary in a heterogeneous sample of ICU patients. [ABSTRACT FROM AUTHOR]

Purpose/goals: This poster will share a study aimed to describe how clinicians were prepared for the transition from a multi-patient room (MPR) intensive care unit (ICU) to a novel single-patient room (SPR) ICU. More specifically, how tailored preparation strategies to various clinicians' roles helped build clinician readiness for the transition to a novel SPR ICU by facilitating the adaptation process. This study further explores the initial work experiences and ongoing challenges experienced by ICU clinicians and how these challenges must be addressed and overcome to better meet their needs and expectations. Outcome 1: Describe the various preparation strategies used in the transition to a SPR ICU Outcome 2: Understand the impact of preparation strategies on ICU clinicians' readiness for change Outcome 3: Outline initial and persisting challenges faced by ICU clinicians during and post transition to a new single-patient room ICU Outcome 4: Provide strategies to address initial and persistent challenges experienced by ICU clinicians Description: This poster presentation will summarize the results of a 2017 study on the preparation, readiness and transition of 29 intensive care unit (ICU) clinicians from a multi-patient room ICU to a single-patient room (SPR) ICU at a hospital in Montreal, Quebec. Recent advances in evidence- based ICU design have established SPR ICUs as the gold standard for patient care. Despite this, there is a major gap in the literature rigorously outlining the impact that the SPR ICU unit has on ICU clinicians' experiences in terms of their preparation, readiness, transition, adaptation and post-transition perceptions. Critical care managers and leaders have little in terms of evidence-based literature that looks to better understand clinician experiences and better prepare their staff for this type of major transition. The purpose and objectives of this study look to describe how clinicians were prepared for the transition to a novel SPR ICU and their work experience during this transition. This robust qualitative study methodology was guided with a readiness for change conceptual framework, particularly relevant as understanding and being able to increase readiness for change among clinicians has been demonstrated to better prepare them for transitions. The results gathered through focus group interviews of 29 ICU clinicians shed light on preparation methods, staff readiness for change, outcomes, and challenges during the transition to this novel type of unit. The challenges experienced by clinicians and propose methods to address them are also elaborated. [ABSTRACT FROM AUTHOR]