The process of implementing a pain assessment scale for patients with brain injuries: Description of a project methodology based on the integrated model of consultation
Background: in a neurosurgery unit, nurses selected the Critical-Care Pain Observation Tool (CPOT) scale to assess pain in brain-injured patients. However, months after implementation, nursing managers have observed an underutilization. Objectives: to support a care team to overcome the pitfalls encountered during the implementation of the CPOT scale for brain-injured patients in a neurosurgery unit. Methods: Lescarbeau, Payette, and St-Arnaud’s integrated model of consultation was selected. In addition to a scientific literature review, a self-administered questionnaire and three interview guides were developed to gather the views of caregivers. Results: the process allowed us to identify the pitfalls in interprofessional collaboration, the CPOT scale, and in implementation processes. Improving interprofessional collaboration and the adaptation of the CPOT scale for brain-injured patients were identified as priority actions. Discussion: a rigorous methodology, the mutual recognition of clinical skills, and the development of a relationship of trust are prerequisites for the success of clinical innovation. Conclusion: the model used is a methodology of choice that allows us to take into consideration both the evidence and the preferences of all actors at every step of the process. This leads to informed choices being made, and to the establishment of priority actions in order to successfully implement CPOT.
Keywords
- evidence-based practice
- pain
- brain injuries
- project methodology
- change
- systemic approach