Pain and pain-related side effects in an ICU and on a surgical unit: nurses' management

Am J Crit Care. 1994 Jan;3(1):25-30.

Abstract

Background: Little research was found to indicate that pain is managed well in hospitalized patients and few studies were found regarding pain management for critical care patients.

Objective: To determine the extent to which nurses manage pain effectively without side effects related to narcotic analgesics in an intensive care and a surgical unit.

Methods: The sample consisted of 44 patients, 20 from an intensive care unit and 24 from a surgical unit. Patients completed a Visual Analogue Scale to measure pain intensity three times in 24 hours. The narcotic side effects of constipation and sedation were measured using the Constipation Assessment Scale and a sedation scale. Documentation was assessed using the Chart Audit for Pain.

Results: Patients in both units continued to experience pain even with pain management interventions. The critical care nurses administered an average of 30% of the maximum narcotic dose ordered and the surgical unit nurses, 36.8%. Documentation of the effect of the pain medication was scant on both units. Although sedation was not a problem in either unit, the majority of patients reported symptoms of constipation. Documentation of this problem was scant in both units.

Conclusions: Results from this study suggest that nurses in both intensive care and surgical units do not appropriately assess, manage or evaluate pain and pain-related side effects. Patients who experience pain expect to have their pain controlled. Efforts must be made to change nurses' pain management behaviors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects*
  • Constipation / chemically induced
  • Critical Care / standards*
  • Documentation
  • Female
  • Florida
  • Humans
  • Intensive Care Units / standards*
  • Male
  • Middle Aged
  • Nursing Records
  • Nursing Staff, Hospital / standards*
  • Nursing Staff, Hospital / statistics & numerical data
  • Pain / drug therapy*
  • Pain / nursing*
  • Pain Management
  • Pain Measurement
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / nursing
  • Pain, Postoperative / therapy
  • Postoperative Care / standards*

Substances

  • Analgesics, Opioid