EVIDENCE-BASED PAIN MANAGEMENT NURSING PRACTICE IN CRITICALLY Ill TRAUMA PATIENTS: A CASE STUDY REPORT

Abstract

Purpose : In critical care settings, many patients are unable to self-report regarding pain and face many other barriers which are compromised by the effective use of analgesics. This study was done to apply and evaluate the selected pain assessment tool for critically ill and for the patient failing to self-report in order to implement the evidence-based nursing intervention and to maximize pain relief.

Methods: This is a case study report. Four critically ill patients who were experiencing pain and unable to self­ report pain in trauma were conveniently selected. Researchers applied the Critical-Care Pain Observation Tool (CPOT), for assessing pain in the patients and implemented the evidence-based nursing intervention, foot and hand massage, for reducing pain. The applicability of the CPOT and the effectiveness of foot and hand massage have been discussed in the present paper.

Results : The CPOT has showed good sensitivity. For patient 1, the CPOT pain score increased  from 2 and  l  before suction to 4 and 5 during suction respectively. For patient 2, the score increased from O before dressing change to 2 during dressing  change.  For  patient  3, the score decreased  from  8  before  administrating analgesics to 1 after administrating analgesics. Moreover, the CPOT score (8) was consistent with the self-report pain level (severe pain) in patient 3. The massage appeared to be effective in reducing pain. For patient  3,  the  score decreased from 8 before massage to 4 immediately after massage and similarly for patients 4 the score also decreased  from  3 to 2.

Conclusion : Although the degree of representation of the results is limited to a sample of four patients. The present study recommended the utility of the CPOT pain tool and foot and hand massage for managing pain in critically ill patients.