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Measuring quality indicators to improve pain management in critically ill patients.

Authors :
Roos-Blom MJ
Gude WT
Spijkstra JJ
de Jonge E
Dongelmans D
de Keizer NF
Source :
Journal of critical care [J Crit Care] 2019 Feb; Vol. 49, pp. 136-142. Date of Electronic Publication: 2018 Oct 30.
Publication Year :
2019

Abstract

Purpose: To evaluate the quality of pain assessment in Dutch ICUs and its room for improvement.<br />Materials and Methods: We used a modified RAND method to develop pain assessment indicators. We measured performance on the indicators using retrospectively collected pain measurement data from Dutch ICUs, which are all mixed medical - surgical, of three months within October 2016-May 2017. We assessed the room for improvement, feasibility of data collection, and reliability of the indicators.<br />Results: We defined four pain assessment indicators. We analyzed 45,688 patient-shift observations from 15 ICUs. In 69.2% (IQR 58.7-84.9) of the patient-shifts pain was measured at least once (indicator 1); in 56.7% (IQR 49.6-73.5) pain scores were acceptable (indicator 2); in 11.7% (IQR 5.6-26.4) pain measurements with unacceptable scores were repeated within 1 h (indicator 3); and in 10.9% (IQR 5.1-20.1) unacceptable scores normalized within 1 h (indicator 4). We found data collection feasible because data were available for >79.3% of the admissions, and all indicators reliable as they produced consistent performance scores.<br />Conclusions: There is substantial variation in pain assessment across Dutch ICUs, and ample room for improvement. With this study we took a first step towards quality assurance of pain assessment in Dutch ICUs.<br /> (Copyright © 2018 Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1557-8615
Volume :
49
Database :
MEDLINE
Journal :
Journal of critical care
Publication Type :
Academic Journal
Accession number :
30419547
Full Text :
https://doi.org/10.1016/j.jcrc.2018.10.027