Implantation des meilleures pratiques de gestion de la douleur à l'unité des soins intensifs de traumatologie: un travail d'équipe


Céline Gélinas

CIUSSS du Centre-Ouest-de-l'Île-de-Montréal


Domaine : neurosciences, santé mentale et toxicomanies

Programme Consortium pour le développement de la recherche en traumatologie - Volet 3

Concours 2018-2019

Individuals hospitalized in the intensive care unit (ICU) after a trauma experience significant pain. Although some of them are able to self-report their pain, others are unable to communicate due to their critical health condition or the use of medication that puts them to sleep. While they are fighting for their lives, those individuals deserve to have their pain adequately evaluated and relieved. Pain that is left undetected and under-treated can lead to multiple complications and a longer stay in the ICU. Regular evaluations of pain using appropriate tools that are adapted to the individual's capacity to communicate are necessary to help provide suitable pain control. The main goal of this knowledge translation project is to implement an evidence-based intervention of pain assessment and management for individuals who suffered a trauma and are hospitalized in the ICU, to evaluate if it is applied by health professionals of the care team on a daily basis and if this practice sustains over time, and if it helps to reduce pain in these individuals.

This intervention will be implemented in 3 ICUs of secondary and tertiary trauma centres in Quebec. Data related to pain management practices (e.g., documentation of pain assessments, analgesic administration and effectiveness of analgesia), teamwork, and individuals' experience of pain while in the ICU will be described at pre-implementation, at post-implementation and at 12 months follow-up. Patient outcomes including incidence of significant pain episodes (i.e., moderate to severe levels of pain), complications (e.g., important changes in heart rate, delirium, infection), ICU length of stay, and mechanical ventilation duration will also be described. Key outcomes of this knowledge translation project are to improve pain control practices in trauma ICU individuals, and to reduce the incidences of significant pain and their complications.