Survey of assessment and management of pain for critically ill adults

Intensive and Critical Care Nursing

Volumn 27, Issue 3, 2011, Pages 121-128

  Rose, Louise ^a   Haslam, Lynn ^b   Dale, Craig ^b   Knechtel, Leasa ^b   Fraser, Melanie ^b   Pinto, Ruxandra ^b   McGillion, Michael ^a   Watt Watson, Judy ^a  

^a UNIVERSITY OF TORONTO   (Canada)

^b SUNNYBROOK RESEARCH INSTITUTE   (Canada)

Author keywords

Critical care; Nurses'role; Pain assessment; Survey

Indexed keywords

ADULT; ARTICLE; CRITICAL ILLNESS; HUMAN; INFORMATION PROCESSING; NURSING; PAIN; PAIN ASSESSMENT;

ADULT; CRITICAL ILLNESS; DATA COLLECTION; HUMANS; PAIN; PAIN MEASUREMENT;

EID: 79955616723     PISSN: 09643397     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.iccn.2011.02.001     Document Type: Article

References (55)

1. Arroyo-Novoa C., Figueroa-Ramos M., Puntillo K., Stanik-Hutt J., Thompson C., White C., et al. Pain related to tracheal suctioning in awake acutely and critically ill adults: a descriptive study. Intens Crit Care Nurs 2008, 24:20-27.
2. Beilin B., Bessler H., Mayburd E., Smirnov G., Dekel A., Yardeni I., et al. Effects of preemptive analgesia on pain and cytokine production in the postoperative period. Anesthesiology 2003, 98:151-155.
3. Benedetti C., Bonica J., Belluci G. Pathophysiology and therapy of post-operative pain: a review. Recent advances in the management of pain 1984, Raven press, New York. C. Benedetti, C. Chapman, G. Moricca (Eds.).
4. Bertolini G., Minelli C., Latronico N., Cattaneo A., Mura G., Melotti R., et al. The use of analgesic drugs in postoperative patients: the neglected problem of pain control in intensive care units. An observational, prospective, multicenter study of 128 Italian intensive care units. Eur J Clin Pharmacol 2002, 58:73-77.
5. Boyle M., Murgo M., Adamson H., Gill J., Elliot D., Crawford M. The effect of chronic pain on health-related quality of life amongst intensive care survivors. Aust Crit Care 2004, 17:108-113.
6. Burns K., Duffett M., Kho M., Meade M., Adhikari N., Sinuff T., et al. A guide for the design and conduct of self-administered surveys of clinicians. CMAJ 2008, 179:245-252.
7. Canadian Nurses Association RN workforce profiles by area of responsibility: year 2007 2009, Canadian Nurses Association, Ottawa.
8. Chanques G., Sebbane M., Barbotte E., Viel E., Eledjam J.-J., Jaber S. A prospective study of pain at rest: incidence and characteristics of an unrecognized symptom in surgical and trauma versus medical intensive care unit patients. Anesthesiology 2007, 107:858-860.
9. Christensen B., Thunedborg L. Use of sedatives, analgesics and neuromuscular blocking agents in Danish ICUs 1996/1997. Intens Care Med 1999, 25:186-191.
10. CNA. Number of RNs with valid CNA Certification by year and specialty, 2001-2005, Ottawa; 2006. Available at: (confirmed 2nd November 2010). http://www.cna-nurses.ca/CNA/documents/pdf/publications/Certifications_by_Year_Spec_2001-2005_e.pdf.
11. Cullen L., Greiner M., Titler M. Pain management in the culture of critical care. Crit Care Nurs Clin N Am 2001, 13:151-163.
12. Desai P. Pain management and pulmonary dysfunction. Crit Care Clin 1999, 15:151-166.
13. Desbiens N., Mueller-Rizner N., Connors A., Wenger N., Lynn J. The symptom burden of seriously ill hospitalized patients. J Pain Symp Manage 1999, 17:248-255.
14. Dillman D. Mail and internet surveys 2000, John Wiley & Sons, New York.
15. Ely E., Shintani A., Truman B., Speroff T., Gordon S., Harrell F., et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 2004, 291:1753-1762.
16. Feldt K. The checklist of nonverbal pain indicators (CNPI). Pain Manage Nurs 2000, 1:13-21.
17. Frank A., Moll J., Hurt J. A comparison of three ways of measuring pain. Rheumatol Rehabil 1982, 21:211-217.
18. Freire A., Afessa B., Cawley P., Phelps S., Bridges L. Characteristics associated with analgesia ordering in the intensive care unit ad relationships with outcome. Crit Care Med 2002, 30:2468-2472.
19. Gelinas C., Fillion L., Puntillo K.A., Viens C., Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care 2006, 15:420-427.
20. Gelinas C., Fortier M., Viens C., Fillion L., Puntillo K. Pain assessment and management in critically ill intubated patients: a retrospective study. Am J Crit Care 2004, 13:126-135.
21. Gelinas C., Harel F., Fillion L., Puntillo K., Johnston C. Sensitivity and specificity of the critical-care pain observation tool for the detection of pain in intubated adults after cardiac surgery. J Pain Sympt Manage 2009, 37:58-67.
22. Gelinas C., Johnston C. Pain assessment in the critically ill ventilated adult: validation of the critical-care pain observation tool and physiologic indicators. Clin J Pain 2007, 23:497-505.
23. Gelinas C., Viens C., Fortier M., Fillion L. Les indicateurs de la douleur en soins critiques. Perspect Infirm 2005, 2:12-22.
24. Giacino J., Ashwal S., Childs N., Cranford R., Jennett B., Katz D., et al. The minimally conscious state: definition and diagnostic criteria. Neurology 2002, 58:349-353.
25. Hall-Lord L., Larsson G., Steen B. Pain and distress among elderly intensive care unit patients: comparison of patients' experiences and nurses' assessments. Heart Lung 1998, 27:123-132.
26. IASP Task Force on Taxonomy Part III: Pain terms, a current list with definitions and notes on usage. Classification of chronic pain 1994, 209-214. IASP Press, Seattle. 2nd edn. H. Merskey, N. Bogduk (Eds.).
27. Jensen M., Karoly P., Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain 1986, 27:117-126.
28. Joyce C., Zutshi D., Hrubes V., Mason R. Comparison of fixed interval and Visual Analogue Scales for rating chronic pain. Eur J Clin Pharmcol 1975, 8:415-420.
29. Kehlet H. Pain relief and modification of the stress response. Acute pain management 1986, Churchill Livingstone, New York. M. Cousins, G. Phillips (Eds.).
30. Kwekkeboom K., Herr K. Assessment of pain in the critically ill. Crit Care Nurs Clin N Am 2001, 13:181-194.
31. Lewis K., Whipple J., Michael K., Quebbeman E. Effect of analgesic treatment on the physiological consequences of acute pain. Am J Hosp Pharm 1994, 51:1539-1554.
32. Li D., Puntillo K., Miaskowski C. A review of objective pain measures for use with critical care adult patients unable to self-report. J Pain 2008, 9:2-10.
33. Ljungqvist O., Nygren J., Soop M., Thorell A. Metabolic perioperative management: novel concepts. Curr Opin Crit Care 2005, 11:295-299.
34. Martin J., Parsch A., Franck M., Wernecke K., Fischer M., Spies C. Practice of sedation and analgesia in German intensive care units: results of a national survey. Crit Care 2005, 9:117-123.
35. Mateo O., Krenzischek D. A pilot study to assess the relationship between behavioural manifestations and self-report of pain in postanaesthesia care unit patients. J Post Anesth Nurs 1992, 7:15-21.
36. Mehta S., Burry L., Fischer S., Martinez-Motta C., Hallett D., Bowman D., et al. Canadian survey of the use of sedatives, analgesics, and neuromuscular blocking agents in critically ill patients. Crit Care Med 2006, 34:374-380.
37. MOHLTC. Laying the foundation for change. Ministry of Health and Long-Term Care and the Ministry of Training, Colleges and Universities; 2005. Available at: (confirmed 2nd November 2010). http://www.health.gov.on.ca/english/public/pub/ministry_reports/hhr_05/hhr_05.pdf.
38. MOHLTC. Critical care nurse training standards task group final report, Ontario; 2006. Available at: (confirmed 2nd November 2010). http://www.health.gov.on.ca/english/providers/program/critical_care/docs/report_ccn_stds.pdf.
39. Odhner M., Wegman D., Freeland N., Steinmetz A., Ingersoll G. Assessing pain control in nonverbal critically ill adults. Dimens Crit Care Nurs 2003, 22:260-267.
40. Ontario Critical Care and LHIN Leadership Table. Inventory of critical care services. Toronto: Ministry of Health and Longterm Care; 2006. Available at (confirmed 2nd November 2010). http://www.health.gov.on.ca/.../critical_care/docs/report_cc_inventory.pdf.
41. Payen J.-F., Bru O., Bosson J.-L., Lagrasta A., Novel E., Deschaux I., et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med 2001, 29:2258-2263.
42. Puntillo K Pain experiences of intensive care unit patients. Heart Lung 1990, 19:526-533.
43. Puntillo K., Weiss S. Pain: its mediators and associated morbidity in critically ill cardiovascular surgical patients. Nurs Res 1994, 43:31-37.
44. Puntillo K., White C., Bonham Morris A., Perdue S., Stanik-Hutt J., Thompson C., et al. Patients' perceptions and responses to procedural pain: results from Thunder Project II. Am J Crit Care 2001, 10:238-251.
45. Puntillo K.A., Miaskowski C., Kehrle K., Stannard D., Gleeson S., Nye P. Relationship between behavioral and physiological indicators of pain, critical care patients' self-reports of pain, and opioid administration. Crit Care Med 1997, 25:1159-1166.
46. Puntillo K.A., Morris A.B., Thompson C.L., Stanik-Hutt J., White C.A., Wild L.R. Pain behaviors observed during six common procedures results from Thunder Project II. Crit Care Med 2004, 32:421-427.
47. Rabuel C., Renaud E., Brealey D., Ratajczak P., Damy T., Alves A., et al. Human septic myopathy: induction of cyclooxygenase, heme oxygenase and activation of the ubiquitin proteolytic pathway. Anesthesiology 2004, 101:583-590.
48. Rotondi A., LChelluri L., Sirio C., Mendelsohn A., Schulz R., Belle S., et al. Patients' recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit. Crit Care Med 2002, 30:746-752.
49. Soliman H., Melot C., Vincent J.-L. Sedative and analgesic practice in the intensive care unit: the results of a European survey. Br J Anaesth 2001, 87:186-192.
50. Stannard D., Puntillo K., Miaskowski C., Gleeson S., Kehrle K., Nye P. Clinical judgment and management of postoperative pain in critical care patients. Am J Crit Care 1996, 5:433-441.
51. Turina M., Miller F., Tucker C., Polk H. Short-term hyperglycemia in surgical patients and a study of related cellular mechanisms. Ann Surg 2006, 243:845-851.
52. Watt-Watson J. Misbeliefs about pain. Pain management: a nursing perspective 1992, 36-58. Mosby, St Louis. J. Watt-Watson, M. Donovan (Eds.).
53. Watt-Watson J., Clark A., Finley A., Watson P. Canadian Pain Society position statement on pain relief. Pain Res Manage 1999, 4:75.
54. Watt-Watson J., Stevens B., Garfinkel P., Streiner D., Gallop R. Relationship between nurses' pain knowledge and pain management outcomes for their postoperative cardiac patients. J Adv Nurs 2001, 36:535-545.
55. Whipple J., Lewis K., Quebbeman E., Wolff M., Gottlieb M., Medicus-Bringa M., et al. Analysis of pain management in critically ill patients. Pharmacotherapy 1995, 15:592-599.