Implementation of a pain management algorithm in intensive care units and evaluation of nurses' level of adherence with the algorithm

Abstract

Objectives: To implement a pain management algorithm in intensive care units (ICU) and to evaluate nurses' level of adherence with the algorithm.

Background: Many ICU patients experience pain. Therefore, an evidence-based algorithm for pain management was developed.

Methods: A pain management algorithm was implemented in three units over three weeks. Nurses' level of adherence with the algorithm and associations between level of adherence and patient and unit characteristics over 22 weeks were evaluated using multivariate regression analysis.

Results: Nurses' level of adherence was 74.6%. Adherence rates were lower on the evening and night shifts compared to the day shift. Males were assessed significantly less frequently than females. Patients with "injury, poisoning, or certain other consequences of external causes" were assessed significantly less frequently than patients with "diseases of the respiratory system."

Conclusions: ICU nurses can use a pain management algorithm consistently. Findings from this study suggest that a pain management algorithm is a useful tool to increase ICU nurses' adherence with pain assessment.

Keywords: Acute pain; Critical care; Intensive care unit; Pain assessment; Pain management; Pain management algorithm.