Evaluation of Critical Care Nurses Utilization of Pain Assessment Tools in Clinical Practice

Abstract

Background: Unmanaged pain among critically ill patients is a primary stressor that leads to acute and long-term complications, increased mortality, and a decline in patient outcomes (Chookalayia et al., 2018; Gélinas, 2010). This project inquiry aims to evaluate TMC critical care nurses’ utilization of BPS and NVPS pain assessment tools used and the amount of analgesics used in clinical practice. Methods: A retrospective chart review on 16 ventilated patients requiring analgesic administration to (1) to evaluate nurses’ utilization of the BPS and NVPS pain assessment tools to guide analgesic administration and (2) determine if the pain assessment scores correlate with the current pain scale used and analgesics given for pain control, and utilization of RASS to guide sedation administration used in clinical practice. Results: Of the 16 patients evaluated approximately 25.8% of the time were critical care nurses compliant in documenting NVPS with analgesic titrations and 24.5% compliant in recording BPS with analgesic titrations. This data showed that critical care nurses used both pain scales successfully 30.5% of the time when titrating analgesia. Conclusion: The literature supports the use of NVPS or BPS as a pain assessment tool to guide titration of analgesics in the general population admitted to the ICU requiring mechanical ventilation (Bouajram et al., 2018; Rijkenberg et al., 2017). However, this DNP project showed low compliance with using validated tools NVPS or BPS, indicating that the current practice utilized at Tucson Medical Center (TMC) does not correspond to the current literature. Future studies could explore a nurse's perspective on ease of use and effectiveness of the NVPS or BPS for assessing pain to the general population admitted to the ICU requiring mechanical ventilation.