Ocena bolečine pri pacientu v enoti intenzivne terapije : diplomsko delo

Kanalec, Blaž (author), Gogova, Tina (mentor), Vahčič, Mija (comentor), Thaler, Darja (reviewer)

Bolečina je pri kritično bolnih pacientih pogost problem. Zaradi komunikacijskih ovir kot so sedacija, delirij, intubacija in živčno-mišični bloki, pacienti v enotah intenzivne terapije težko izražajo bolečino. Poznavanje ustreznih validiranih lestvic bolečine je za enoto intenzivne terapije ključnega pomena. S pravilno in pravočasno oceno bolečine se zmanjša nelagodje, lahko se vpliva na skrajšanje ležalne dobe ter pripomore k boljšemu izidu zdravljenja. Namen: Namen diplomskega dela je s pomočjo relevantne literature opisati načine ocenjevanja bolečine pri kritično bolnem odraslem pacientu v enoti intenzivne terapije in predstaviti lestvico CPOT. Metode dela: V diplomskem delu smo uporabili opisno metodo dela pregleda literature, ki je v večini temeljila na tuji strokovni in znanstveni literaturi. Iskanje literature je potekalo s pomočjo ključnih besed: ocenjevanje bolečine IN zdravstvena nega / pain assessment AND nursing, lestvice za ocenjevanje bolečine / pain rating scales, bolečina IN intenzivna terapija / pain AND intensive care unit, ocena in obvladovanje bolečine IN smernice / pain assessment and managment AND guidelines, Critical Care Pain Observation Tool. Uporabili smo literaturo, ki je bila v celoti prosto dostopna na spletu in objavljena od leta 2014 do 2024. Rezultati: Podrobno smo pregledali 12 enot literature. Ugotovili smo, da so prednosti uporabe lestvice CPOT objektivnost, enostavnost uporabe, zanesljivost in standardizacija uporabe ter občutljivost zaznavanja bolečine. Slabosti uporabe lestvice CPOT so subjektivnost v primeru manj izkušenih zdravstvenih delavcev, časovna zahtevnost, potreba po kontinuiranem spremljanju in ocenjevanju bolečine ter izobraževanju in usposabljanju zdravstvenih delavcev in to, da je uporaba lestvice omejena za določeno skupino pacientov. Razprava in zaključek: Medicinske sestre imajo v enoti intenzivne terapije ključno vlogo pri ocenjevanju in obvladovanju bolečine. Njihova vloga vključuje redno in dosledno uporabo lestvice CPOT za ocenjevanje bolečine, spremljanje stanja pacientov in prilagajanje terapevtskih ukrepov glede na rezultate ocene bolečine. Menimo, da je na področju ocenjevanja bolečine še veliko prostora za napredek, ki bi pripomogel k učinkovitejšemu, natančnejšemu in bolj prilagojenemu pristopu pri obvladovanju bolečine pri kritično bolnih pacientih. Zaključimo lahko, da je uporaba lestvice CPOT koristna za ocenjevanje bolečine pri kritično bolnih pacientih in predstavlja pomembno orodje za izboljšanje obvladovanja bolečine in zagotavljanje celostne oskrbe v enoti intenzivne terapije.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, sedacija, ocenjevalne lestvice bolečine, CPOT
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [B. Kanalec]
• Year: 2024
• Number of pages: 25 str.
• UDC: 616-083
• COBISS.SI-ID: 206832131
• Publication date in RUL: 08.09.2024

Secondary language

• Language: English
• Title: Pain assessment in the intensive care unit patient : diploma work

Abstract

Introduction: Pain is a common problem among critically ill patients. Due to communication barriers such as sedation, delirium, intubation, and neuromuscular blocks, patients in intensive care units find it difficult to express their pain. Understanding appropriate validated pain scales is crucial for intensive care units. Proper and timely pain assessment can reduce discomfort, shorten the length of stay, and contribute to better treatment outcomes. Purpose: The purpose of this thesis is to describe the methods of pain assessment in critically ill adult patients in intensive care units using relevant literature and to present the Critical-Care Pain Observation Tool. Methods: In this thesis, we used a descriptive literature review method, primarily based on foreign professional and scientific literature. The literature search was conducted using the following keywords: pain assessment AND nursing, pain rating scales, pain AND intensive care unit, pain assessment and management AND guidelines and Critical Care Pain Observation Tool. The literature used was fully accessible online and published between 2014 and 2024. Results: We conducted a detailed review of 12 literature sources. We found that the advantages of using the CPOT include objectivity, ease of use, reliability, standardization of use, and sensitivity in detecting pain. The disadvantages of using the CPOT are subjectivity in the case of less experienced healthcare workers, time consumption, the need for continuous monitoring and pain assessment, the necessity for education and training of healthcare workers, and the limitation of its use to a specific group of patients. Discussion and conclusion: Nurses play a crucial role in intensive care units in assessing and managing pain. Their role includes the regular and consistent use of the CPOT for pain assessment, monitoring patient conditions, and adjusting therapeutic measures based on pain assessment results. We believe that there is a lot to improve in pain assessment, which would contribute to a more effective, accurate, and tailored approach to pain management in critically ill patients. It can be concluded that the use of the CPOT is beneficial for pain assessment in critically ill patients and represents an important tool for improving pain management and ensuring comprehensive care in ICUs

• Keywords: diploma theses, nursing care, sedation, pain rating scales, CPOT