Significant pain is very common in critically-ill adult ICU patients and patient self-assessment is not always the best way for nurses to record, report or treat their patients’ needs, according to an article on Advance Healthcare Network for Nurses.
To address this issue, nurses and other medical professionals need to have the right tools, including validated, standardized pain assessment plans, according to nursing experts quoted in the article. The most common verbal scale tool for adult ICU patients is the Verbal Numerical Rating Scale, where pain is rated on a scale from zero to 10. Non-verbal scales consist of patients pointing to a number on a board or paper, and nurses asking the patient to shake their head yes or no while following their facial expressions and vital signs for indications of pain. Another tool is the mnemonic OLDCART:
• O = onset
• L = location
• D = duration
• C = characteristics of the pain on a 0-10 scale
• A = aggravating factors
• R = relieving factors
• T = treatment
Tools for patients who are not able to communicate at all are also outlined in the article.
The INQRI funded study: SPEACS 2: Improving Patient Communication and Quality Outcomes in the ICU examined the value of a nurse-generated and nurse-led innovation on ICU patient care outcomes, including pain symptom management.