Measuring quality indicators to improve pain management in critically ill patients

Marie José Roos-Blom, Wouter T. Gude, Jan Jaap Spijkstra, Evert de Jonge, Dave Dongelmans, Nicolette F. de Keizer

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: To evaluate the quality of pain assessment in Dutch ICUs and its room for improvement. Materials and methods: We used a modified RAND method to develop pain assessment indicators. We measured performance on the indicators using retrospectively collected pain measurement data from Dutch ICUs, which are all mixed medical – surgical, of three months within October 2016–May 2017. We assessed the room for improvement, feasibility of data collection, and reliability of the indicators. Results: We defined four pain assessment indicators. We analyzed 45,688 patient-shift observations from 15 ICUs. In 69.2% (IQR 58.7–84.9) of the patient-shifts pain was measured at least once (indicator 1); in 56.7% (IQR 49.6–73.5) pain scores were acceptable (indicator 2); in 11.7% (IQR 5.6–26.4) pain measurements with unacceptable scores were repeated within 1 h (indicator 3); and in 10.9% (IQR 5.1–20.1) unacceptable scores normalized within 1 h (indicator 4). We found data collection feasible because data were available for >79.3% of the admissions, and all indicators reliable as they produced consistent performance scores. Conclusions: There is substantial variation in pain assessment across Dutch ICUs, and ample room for improvement. With this study we took a first step towards quality assurance of pain assessment in Dutch ICUs.

LanguageEnglish
Pages136-142
Number of pages7
JournalJournal of Critical Care
Volume49
DOIs
Publication statusPublished - 1 Feb 2019

Cite this

Roos-Blom, Marie José ; Gude, Wouter T. ; Spijkstra, Jan Jaap ; de Jonge, Evert ; Dongelmans, Dave ; de Keizer, Nicolette F. / Measuring quality indicators to improve pain management in critically ill patients. In: Journal of Critical Care. 2019 ; Vol. 49. pp. 136-142.
@article{a0a9c75f15e84433b43d1e94a57ce793,
title = "Measuring quality indicators to improve pain management in critically ill patients",
abstract = "Purpose: To evaluate the quality of pain assessment in Dutch ICUs and its room for improvement. Materials and methods: We used a modified RAND method to develop pain assessment indicators. We measured performance on the indicators using retrospectively collected pain measurement data from Dutch ICUs, which are all mixed medical – surgical, of three months within October 2016–May 2017. We assessed the room for improvement, feasibility of data collection, and reliability of the indicators. Results: We defined four pain assessment indicators. We analyzed 45,688 patient-shift observations from 15 ICUs. In 69.2{\%} (IQR 58.7–84.9) of the patient-shifts pain was measured at least once (indicator 1); in 56.7{\%} (IQR 49.6–73.5) pain scores were acceptable (indicator 2); in 11.7{\%} (IQR 5.6–26.4) pain measurements with unacceptable scores were repeated within 1 h (indicator 3); and in 10.9{\%} (IQR 5.1–20.1) unacceptable scores normalized within 1 h (indicator 4). We found data collection feasible because data were available for >79.3{\%} of the admissions, and all indicators reliable as they produced consistent performance scores. Conclusions: There is substantial variation in pain assessment across Dutch ICUs, and ample room for improvement. With this study we took a first step towards quality assurance of pain assessment in Dutch ICUs.",
keywords = "Intensive care units, Pain, Pain assessment, Quality improvement, Quality indicator",
author = "Roos-Blom, {Marie Jos{\'e}} and Gude, {Wouter T.} and Spijkstra, {Jan Jaap} and {de Jonge}, Evert and Dave Dongelmans and {de Keizer}, {Nicolette F.}",
year = "2019",
month = "2",
day = "1",
doi = "10.1016/j.jcrc.2018.10.027",
language = "English",
volume = "49",
pages = "136--142",
journal = "Journal of Critical Care",
issn = "0883-9441",
publisher = "Elsevier BV",

}

Measuring quality indicators to improve pain management in critically ill patients. / Roos-Blom, Marie José; Gude, Wouter T.; Spijkstra, Jan Jaap; de Jonge, Evert; Dongelmans, Dave; de Keizer, Nicolette F.

In: Journal of Critical Care, Vol. 49, 01.02.2019, p. 136-142.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Measuring quality indicators to improve pain management in critically ill patients

AU - Roos-Blom, Marie José

AU - Gude, Wouter T.

AU - Spijkstra, Jan Jaap

AU - de Jonge, Evert

AU - Dongelmans, Dave

AU - de Keizer, Nicolette F.

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Purpose: To evaluate the quality of pain assessment in Dutch ICUs and its room for improvement. Materials and methods: We used a modified RAND method to develop pain assessment indicators. We measured performance on the indicators using retrospectively collected pain measurement data from Dutch ICUs, which are all mixed medical – surgical, of three months within October 2016–May 2017. We assessed the room for improvement, feasibility of data collection, and reliability of the indicators. Results: We defined four pain assessment indicators. We analyzed 45,688 patient-shift observations from 15 ICUs. In 69.2% (IQR 58.7–84.9) of the patient-shifts pain was measured at least once (indicator 1); in 56.7% (IQR 49.6–73.5) pain scores were acceptable (indicator 2); in 11.7% (IQR 5.6–26.4) pain measurements with unacceptable scores were repeated within 1 h (indicator 3); and in 10.9% (IQR 5.1–20.1) unacceptable scores normalized within 1 h (indicator 4). We found data collection feasible because data were available for >79.3% of the admissions, and all indicators reliable as they produced consistent performance scores. Conclusions: There is substantial variation in pain assessment across Dutch ICUs, and ample room for improvement. With this study we took a first step towards quality assurance of pain assessment in Dutch ICUs.

AB - Purpose: To evaluate the quality of pain assessment in Dutch ICUs and its room for improvement. Materials and methods: We used a modified RAND method to develop pain assessment indicators. We measured performance on the indicators using retrospectively collected pain measurement data from Dutch ICUs, which are all mixed medical – surgical, of three months within October 2016–May 2017. We assessed the room for improvement, feasibility of data collection, and reliability of the indicators. Results: We defined four pain assessment indicators. We analyzed 45,688 patient-shift observations from 15 ICUs. In 69.2% (IQR 58.7–84.9) of the patient-shifts pain was measured at least once (indicator 1); in 56.7% (IQR 49.6–73.5) pain scores were acceptable (indicator 2); in 11.7% (IQR 5.6–26.4) pain measurements with unacceptable scores were repeated within 1 h (indicator 3); and in 10.9% (IQR 5.1–20.1) unacceptable scores normalized within 1 h (indicator 4). We found data collection feasible because data were available for >79.3% of the admissions, and all indicators reliable as they produced consistent performance scores. Conclusions: There is substantial variation in pain assessment across Dutch ICUs, and ample room for improvement. With this study we took a first step towards quality assurance of pain assessment in Dutch ICUs.

KW - Intensive care units

KW - Pain

KW - Pain assessment

KW - Quality improvement

KW - Quality indicator

UR - http://www.scopus.com/inward/record.url?scp=85056232941&partnerID=8YFLogxK

U2 - 10.1016/j.jcrc.2018.10.027

DO - 10.1016/j.jcrc.2018.10.027

M3 - Article

VL - 49

SP - 136

EP - 142

JO - Journal of Critical Care

T2 - Journal of Critical Care

JF - Journal of Critical Care

SN - 0883-9441

ER -