title: [Standardized impartial assessment of pain in unconscious patients with the Zurich Observation Pain Assessment on a neurosurgical intensive care unit - a case report].
abstract: BACKGROUND
  International studies show that the majority of patients undergoing treatment in ICUs report moderate to strong levels of pain. It has been established that undetected or insufficiently treated pain can cause severe physical and emotional distress. Therefore, early and effective pain assessment is a primary treatment goal of intensive care, which is a challenge with patients having cognitive impairment.
  
  
  OBJECTIVE
  This article shows how using the Zurich Observation Pain Assessment (ZOPA(©)) as part of a standardized assessment can close this gap.
  
  
  METHODS
  An interpretive single case study evaluates the use of ZOPA(©) in nursing practice and its influence on pain management.
  
  
  RESULTS
  The study case involved an intensive care patient with a severe subarachnoid haemorrhage for whom a total of 126 single ZOPA(©) assessments were analyzed. A total of 19 assessments showed behavioral characteristics indicative of pain. Immediate interventions to alleviate pain were taken in three quarters of these assessments. The study ICU has used ZOPA(©) for the past five years. This unit has a standard medication procedure, so nurses can administer analgesics on an "as needed" basis and take their responsibility in implementing pain management.
  
  
  CONCLUSIONS
  This study supports the finding that ZOPA(©) can contribute to early and effective detection of pain in cognitively impaired patients, resulting in improved pain treatment.
authors: Neurointensiv- und interdisziplinäre Überwachungsstation, Zentrum Klinische Pflegewissenschaft, UniversitätsSpital Zürich.
authors: Jürgen
authors: J
authors: Maier
authors: Neurointensiv- und interdisziplinäre Überwachungsstation, Zentrum Klinische Pflegewissenschaft, UniversitätsSpital Zürich.
authors: Martin R
authors: MR
authors: Fröhlich
authors: Neurointensiv- und interdisziplinäre Überwachungsstation, Zentrum Klinische Pflegewissenschaft, UniversitätsSpital Zürich.
authors: Rebecca
authors: R
authors: Spirig
mesh_terms: D000465:Algorithms; D000701:Analgesics, Opioid / Q000627:therapeutic use; D017542:Aneurysm, Ruptured / Q000451:nursing / Q000601:surgery; D016292:Procedural Sedation / Q000451:nursing; D005260:Female; D015600:Glasgow Coma Scale / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units; D002532:Intracranial Aneurysm / Q000451:nursing / Q000601:surgery; D008875:Middle Aged; D010147:Pain Measurement / Q000451:nursing*; D010149:Postoperative Pain / Q000451:nursing / Q000523:psychology; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D013345:Subarachnoid Hemorrhage / Q000451:nursing* / Q000523:psychology / Q000601:surgery; D013557:Switzerland
chemical_list: D000701:Analgesics, Opioid
keywords: Intensivpflege; Schmerzassessment; bewusstseinseingeschränkte Patienten; cognitive impaired patients; intensive care; pain assessment