title: Results of implementing a pain management algorithm in intensive care unit patients: The impact on pain assessment, length of stay, and duration of ventilation.
abstract: This study aimed to measure the impact of implementing a pain management algorithm in adult intensive care unit (ICU) patients able to express pain. No controlled study has previously evaluated the impact of a pain management algorithm both at rest and during procedures, including both patients able to self-report and express pain behavior, intubated and nonintubated patients, throughout their ICU stay.
  
  
  
  The algorithm instructed nurses to assess pain, guided them in pain treatment, and was implemented in 3 units. A time period after implementing the algorithm (intervention group) was compared with a time period the previous year (control group) on the outcome variables: pain assessments, duration of ventilation, length of ICU stay, length of hospital stay, use of analgesic and sedative medications, and the incidence of agitation events.
  
  
  
  Totally, 650 patients were included. The number of pain assessments was higher in the intervention group compared with the control group. In addition, duration of ventilation and length of ICU stay decreased significantly in the intervention group compared with the control group. This difference remained significant after adjusting for patient characteristics.
  
  
  
  Several outcome variables were significantly improved after implementation of the algorithm compared with the control group.
authors.affiliation: Intensive and Post Operative Unit, Østfold Hospital Trust, Postbox 300, 1714 Grålum, Norway; Division of Emergencies and Critical Care, Oslo University Hospital, Postbox 4950, Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Postbox 1078, 0316 Oslo, Norway. Electronic address: Brita.Fosser.Olsen@so-hf.no.
authors.forename: Brita F
authors.initials: BF
authors.lastname: Olsen
authors.affiliation: Division of Emergencies and Critical Care, Oslo University Hospital, Postbox 4950, Nydalen, 0424 Oslo, Norway; Institute of Health and Society, Department of Nursing Science, Faculty of Medicine, University of Oslo, Postbox 0316, Oslo, Norway.
authors.forename: Tone
authors.initials: T
authors.lastname: Rustøen
authors.affiliation: Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, Postbox 1122, Blindern, 0317 Oslo, Norway.
authors.forename: Leiv
authors.initials: L
authors.lastname: Sandvik
authors.affiliation: Norwegian University of Life Sciences, Postbox 5003, 1432 Ås, Norway; Faculty of Medicine, University of Oslo, Postbox 0316, Oslo, Norway; Department of Medicine, Østfold Hospital Trust, Postbox 300, 1714 Grålum, Norway.
authors.forename: Morten
authors.initials: M
authors.lastname: Jacobsen
authors.affiliation: Oslo and Akershus University College of Applied Sciences, Postbox 4, St Olavs plass, 0130 Oslo, Norway.
authors.forename: Berit T
authors.initials: BT
authors.lastname: Valeberg
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000700:Analgesics / Q000627:therapeutic use*; D003422:Critical Care / Q000379:methods; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009664:Norway; D010146:Pain / Q000150:complications / Q000188:drug therapy / Q000451:nursing*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011595:Psychomotor Agitation / Q000453:epidemiology; D012121:Respiration, Artificial / Q000706:statistics & numerical data*
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives
keywords: Acute pain; Algorithms; Critical care; Intensive care units; Pain; Pain management