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Measuring quality indicators to improve pain management in critically ill patients.
- 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.)
- Subjects :
- Data Collection
Feasibility Studies
Humans
Intensive Care Units statistics & numerical data
Pain Management standards
Quality Improvement
Quality Indicators, Health Care
Reproducibility of Results
Retrospective Studies
Critical Care standards
Critical Illness therapy
Pain prevention & control
Pain Measurement standards
Subjects
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