Marie-José Roos-Blom1, Wouter T Gude2, Jan Jaap Spijkstra3, Evert de Jonge4, Dave Dongelmans5, Nicolette F de Keizer6. 1. Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health research institute, The Netherlands; National Intensive Care Evaluation (NICE) foundation, Amsterdam, The Netherlands. Electronic address: m.blom@amc.uva.nl. 2. Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health research institute, The Netherlands. 3. National Intensive Care Evaluation (NICE) foundation, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Intensive Care Medicine, Amsterdam, The Netherlands. 4. National Intensive Care Evaluation (NICE) foundation, Amsterdam, The Netherlands; Department of Intensive Care Medicine, Leiden University Medical Center, Leiden, The Netherlands. 5. National Intensive Care Evaluation (NICE) foundation, Amsterdam, The Netherlands; Amsterdam UMC, University of Amsterdam, Department of Intensive Care Medicine, Amsterdam, The Netherlands. 6. Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health research institute, The Netherlands; National Intensive Care Evaluation (NICE) foundation, Amsterdam, The Netherlands.
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.
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.
Authors: Jilske A Huijben; Eveline J A Wiegers; Nicolette F de Keizer; Andrew I R Maas; David Menon; Ari Ercole; Giuseppe Citerio; Fiona Lecky; Lindsay Wilson; Maryse C Cnossen; Suzanne Polinder; Ewout W Steyerberg; Mathieu van der Jagt; Hester F Lingsma Journal: Crit Care Date: 2019-03-22 Impact factor: 9.097
Authors: Carline N L Groenland; Fabian Termorshuizen; Wim J R Rietdijk; Judith van den Brule; Dave A Dongelmans; Evert de Jonge; Dylan W de Lange; Anne Marie G A de Smet; Nicolette F de Keizer; Joachim D Weigel; Lucia S D Jewbali; Eric Boersma; Corstiaan A den Uil Journal: Crit Care Med Date: 2019-11 Impact factor: 7.598
Authors: Wouter T Gude; Marie-José Roos-Blom; Sabine N van der Veer; Dave A Dongelmans; Evert de Jonge; Niels Peek; Nicolette F de Keizer Journal: Implement Sci Date: 2019-09-18 Impact factor: 7.327
Authors: Marie-José Roos-Blom; Wouter T Gude; Evert de Jonge; Jan Jaap Spijkstra; Sabine N van der Veer; Niels Peek; Dave A Dongelmans; Nicolette F de Keizer Journal: BMJ Qual Saf Date: 2019-07-01 Impact factor: 7.035