Pain Assessment in INTensive care (PAINT): an observational study of physician‐documented pain assessment in 45 intensive care units in the United Kingdom. (19th February 2017)

• Record Type: Journal Article
• Authors: Kemp, H. I.; Bantel, C.; Gordon, F.; Brett, S. J.; Laycock, H. C.
• Other Names: Bampoe Sohail investigator.; Bantel Carsten investigator.; Gooneratne Mevan investigator.; Highton David investigator.; Hopkins Phil investigator.; Johnston Carolyn investigator.; Odor Peter investigator.; Kemp Harriet investigator.; Laycock Helen investigator.; Martin Daniel investigator.; O'Carroll James investigator.; Phillips Sioned investigator.; Visram Anil investigator.; Siddique Omar investigator.; Burdett Edward investigator.; May Rosie investigator.; Renwick Sonia investigator.; Gray Martin investigator.; Spiro Michael investigator.; Luoma Val investigator.; Chamarette Holly investigator.; Young Trudy investigator.; Wagstaff Duncan investigator.; Lewith Henry investigator.; Gowrie Shan investigator.; Bramall Jon investigator.; Collison Lucy investigator.; Mansell Josephine investigator.; Hamilton Kevin investigator.; Leigh Alexander investigator.; Dawson Jeremy investigator.; Morkane Clare investigator.; Balla Paul investigator.; Shukla Bhavin investigator.; Rublotta Francesca investigator.; Cousins Jonathan investigator.; Magee David investigator.; Cashell Catherine investigator.; Kooner Gurleen investigator.; Arnold Glenn investigator.; Garnelo Ray Vanessa investigator.; Clancy Olivia investigator.; Whitehead Nicole investigator.; Kooner Gurleen investigator.; Handy Jonathan investigator.; Vizcaychipi Marcella investigator.; Edwards Zara investigator.; Davis‐Hall Melanie investigator.; Addy Melissa investigator.; Jhanji Shaman investigator.; Wigmore Tim investigator.; Christie Linsey investigator.; Sidon Lauren investigator.; Grover Munita investigator.; Panagoda Prasan investigator.; Howells Lara investigator.; Cartwright Charles investigator.; Doyle Richard investigator.; Griffith Megan investigator.; Casely Emma investigator.; Holdgate Andrew investigator.; Rich Stephanie investigator.; Henriksson Maria investigator.; Jaggar Sian investigator.; Tatham Kate investigator.; Kadry Mirian investigator.; Finlay Claire investigator.; Pandit Ajoy investigator.; Mehdipour Savviz investigator.; Ong Cheng investigator.; Bidd Heena investigator.; Ramessur Suneil investigator.; Anwar Sibtain investigator.; Blunt Nadia investigator.; Williams Hannah investigator.; Tosini Chiara investigator.; Parini Alessandra investigator.; Kumar Ravi investigator.; Ferrier Victoria investigator.; Gupta Aman investigator.; Canavan Aoife investigator.; Dickinson Matt investigator.; Carey Ben investigator.; Somasundaram Karthik investigator.; De Silva Samanthi investigator.; Moghulm Arif investigator.; Dua Kanika investigator.; McHugh Barry investigator.; Chapman Rachel investigator.; Peck Marcus investigator.; Sangam Amy investigator.; Al‐Sahaf Hadi investigator.; Gowripalann Tharumalingam investigator.; Kunnumpurath Sreekumar investigator.; Mottaleb Ramy investigator.; Fletcher Kate investigator.; Bhagwat Milind investigator.; Eeles Alex investigator.; Hunningher Annie investigator.; Nesbit Finn investigator.; Turton Danny investigator.; Barringer Chris investigator.; Dannatt Peter investigator.; Shenoy Venkat investigator.; Keogh Peter investigator.; Krishnachetty Bobby investigator.; Mendes Fiona investigator.; Ferns Janis investigator.; Kennedy Charles investigator.; Sandru Roxana investigator.; Husain Naush investigator.; Holler Liesel investigator.; Barnes Lucy investigator.; Thorburn Patrick investigator.; Shippam William investigator.; Lee Sindy investigator.; Mahgoub Sara investigator.;
• Is Part Of: Anaesthesia. Volume 72:Number 6(2017:Jun.)
• Page Start: 737
• Page End: 748
• Publication Date: 2017-02-19
• Subjects: critical care -- intensive care unit -- pain assessment -- pain terms -- physicians; Anesthesia -- Periodicals; 617.96
• DOI: 10.1111/anae.13786
• Languages: English
• ISSNs: 0003-2409

Abstract

Summary: Pain is a common and distressing symptom experienced by intensive care patients. Assessing pain in this environment is challenging, and published guidelines have been inconsistently implemented. The Pain Assessment in INTensive care (PAINT) study aimed to evaluate the frequency and type of physician pain assessments with respect to published guidelines. This observational service evaluation considered all pain and analgesia‐related entries in patients' records over a 24‐h period, in 45 adult intensive care units (ICUs) in London and the South‐East of England. Data were collected from 750 patients, reflecting the practice of 362 physicians. Nearly two‐thirds of patients (n = 475, 64.5%, 95%CI 60.9–67.8%) received no physician‐documented pain assessment during the 24‐h study period. Just under one‐third (n = 215, 28.6%, 95%CI 25.5–32.0%) received no nursing‐documented pain assessment, and over one‐fifth (n = 159, 21.2%, 95%CI 19.2–23.4)% received neither a doctor nor a nursing pain assessment. Two of the 45 ICUs used validated behavioural pain assessment tools. The likelihood of receiving a physician pain assessment was affected by the following factors: the number of nursing assessments performed; whether the patient was admitted as a surgical patient; the presence of tracheal tube or tracheostomy; and the length of stay in ICU. Physician‐documented pain assessments in the majority of participating ICUs were infrequent and did not utilise recommended behavioural pain assessment tools. Further research to identify factors influencing physician pain assessment behaviour in ICU, such as human factors or cultural attitudes, is urgently needed.