title: Efficacy of the use of evidence-based algorithmic guidelines in the acute care setting for pain assessment and management in older people: a critical review of the literature.
abstract: OBJECTIVE
  The aim of the literature review was to identify all examples of primary research using an algorithmic approach for the implementation of a clinical practice guideline relating to pain assessment and/or management within acute care, with a specific focus on older people.
  
  
  METHODS
  Critical literature review.
  
  
  METHODS
  Inclusion criteria were; English language publications within the past 13 years; peer reviewed; research conducted within a hospital; about adult inpatients. Exclusion criteria; research located outside of a hospital context; quality improvement studies; rehabilitation studies and literature reviews.
  
  
  METHODS
  Critical appraisal of the literature by using a qualitative interpretation of a translational approach. The literature was thematically mapped according to the criteria of credibility, transferability, plausibility and applicability.
  
  
  RESULTS
  No clinical practice guideline was found that directly related to both assessment and management of pain using an algorithm in acute care for older people. Five studies were found to have relevance and were critically evaluated.
  
  
  CONCLUSIONS
  A critique of the literature shows that an algorithmic approach is feasible for translation into a clinical practice guideline for assessment and management of pain in older people within the acute care setting.
  
  
  CONCLUSIONS
  Implementation of any algorithmic approach requires consideration of the environment, culture and availability of resources.
authors.affiliation: Division of Surgery, School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia. joanne.harmon@uon.edu.au
authors.forename: Joanne R
authors.initials: JR
authors.lastname: Harmon
authors.forename: Isabel
authors.initials: I
authors.lastname: Higgins
authors.forename: Peter
authors.initials: P
authors.lastname: Summons
authors.forename: Helen
authors.initials: H
authors.lastname: Bellchambers
mesh_terms: D000208:Acute Disease / Q000628:therapy; D000368:Aged; D000465:Algorithms; D055318:Evidence-Based Nursing / Q000592:standards*; D006299:Health Services for the Aged; D006801:Humans; D015404:Nursing Methodology Research; D059408:Pain Management; D010147:Pain Measurement; D011157:Population Dynamics; D017410:Practice Guidelines as Topic