Bold Voices - August 2017 - 9

AT THE BEDSIDE

New Behavior-Based Pain Assessment Tool
The BPAT requires
bedside clinicians
to observe the
presence or lack
of eight items and
record a numeric
rating on a checklist.

T

he new Behavior Pain
Assessment Tool (BPAT),
which uses nonverbal
cues, was effective in identifying severe pain levels in ICU
patients unable to self-report.
"The Behavior Pain
Assessment Tool for Critically
Ill Adults: A Validation Study
in 28 Countries," in PAIN,
explains that clinicians trained
to recognize pain distress through nonverbal signs such as
grimaces and winces measured severe pain similarly for patients
unable to report as for those who were able. The BPAT, tested
on 3,851 patients in 192 ICU settings in 28 countries (except
the U.S.) and in 12 languages, was successful in many European
cultures.
ICU patients often cannot communicate pain levels due
to their condition, mechanical ventilation, sedation or lack of
consciousness. "Because none of these conditions precludes the
perception of pain, it is essential that clinicians have valid and
reliable pain assessment methods," the study adds.

The BPAT requires bedside clinicians to observe the presence
or lack of eight items and record a numeric rating on a checklist. The tool measures four facial expressions (using an artist's
computerized drawings), two verbal responses and two body
muscle responses; one of the items (closed eyes) lacked sufficient clarification.
Clinicians studied each patient for one minute immediately
before a procedure such as moving the patient or removing a
wound drain, then for one more minute during the procedure
when they expected to see the most pain. The study then
compared the assessments with those given by patients who
could respond verbally, and the BPAT "significantly predicted"
the patients' self-report in both pain intensity and distress.
Although the BPAT was reliable and valid, "its feasibility
for use in practice and the effect of its clinical implementation
on patient pain and intensive care unit outcomes need further
research." The study concludes, "The differences in behavioral
expression of pain in an international population are also a relevant topic for further exploration."
REFERENCE: Gélinas C, Puntillo KA, Levin P, Azoulay E. The behavior pain assessment tool for
critically ill adults: a validation study in 28 countries. Pain. 2017;158(5):811-821.

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AACN BOLD VOICES AUGUST 2017

9


http://journals.lww.com/pain/fulltext/2017/05000/The_Behavior_Pain_Assessment_Tool_for_critically.8.aspx http://journals.lww.com/pain/fulltext/2017/05000/The_Behavior_Pain_Assessment_Tool_for_critically.8.aspx http://journals.lww.com/pain/fulltext/2017/05000/The_Behavior_Pain_Assessment_Tool_for_critically.8.aspx http://journals.lww.com/pain/fulltext/2017/05000/The_Behavior_Pain_Assessment_Tool_for_critically.8.aspx http://www.advancedicucare.com http://www.aacn.org/scholarshipsprogram http://www.advancedicucare.com

Table of Contents for the Digital Edition of Bold Voices - August 2017

Another Angle
Pres Note Front Teaser
Masthead
New Online Toolkit Shows Crucial Roles of Nurses in Serious Illness Communication
Oct. 31 Deadline to Apply for AACN Research Grants
PCCN or CCRN: Which Certification Is Right for You?
Failed Resuscitations May Increase Stress for Nurses
Updated Cardiac Nursing Course and CMC Review Course Online
New Behavior-Based Pain Assessment Tool
Hospital Rooftop Is a Hive of Activity
Former ICU Nurse Collects 100K Objects for Medical Mosaic
Interventions Reduce Wrong-Patient Orders in NICUs
Increasing Acceptance of Pediatric Telemedicine
The Privilege of Nursing
Effects of Dexmedetomidine
Seizure Risk Much Higher for Sepsis Survivors
Studies Provide Insights Into Reducing Opioid Use
Short-Term Oral Corticosteroids Increase Risk of Adverse Effects
Hospital Staff Becoming Product Innovators
Addressing Barriers to APRN Practice
Survival Rates Higher During Joint Commission Surveys
Effect of Rudeness on Pediatric Team Performance
Glasgow Coma Scale Stands the Test of Time
ECRI Introduces Patient Identification Tools
Reducing Risk Factors in Pediatric Delirium
Bundle Compliance Increases Survival, Reduces Delirium
Fostering Resilience in Healthcare Professionals Who Are Also Moms
Members: Enhance Your Career With an AACN Scholarship
In Our Journals
Transitions
President’s Note
Bold Voices - August 2017 - Cover1
Bold Voices - August 2017 - Cover2
Bold Voices - August 2017 - Pres Note Front Teaser
Bold Voices - August 2017 - Masthead
Bold Voices - August 2017 - Oct. 31 Deadline to Apply for AACN Research Grants
Bold Voices - August 2017 - PCCN or CCRN: Which Certification Is Right for You?
Bold Voices - August 2017 - 7
Bold Voices - August 2017 - Updated Cardiac Nursing Course and CMC Review Course Online
Bold Voices - August 2017 - New Behavior-Based Pain Assessment Tool
Bold Voices - August 2017 - Former ICU Nurse Collects 100K Objects for Medical Mosaic
Bold Voices - August 2017 - Increasing Acceptance of Pediatric Telemedicine
Bold Voices - August 2017 - The Privilege of Nursing
Bold Voices - August 2017 - 13
Bold Voices - August 2017 - Seizure Risk Much Higher for Sepsis Survivors
Bold Voices - August 2017 - Short-Term Oral Corticosteroids Increase Risk of Adverse Effects
Bold Voices - August 2017 - Addressing Barriers to APRN Practice
Bold Voices - August 2017 - Effect of Rudeness on Pediatric Team Performance
Bold Voices - August 2017 - ECRI Introduces Patient Identification Tools
Bold Voices - August 2017 - Bundle Compliance Increases Survival, Reduces Delirium
Bold Voices - August 2017 - Members: Enhance Your Career With an AACN Scholarship
Bold Voices - August 2017 - Transitions
Bold Voices - August 2017 - President’s Note
Bold Voices - August 2017 - Cover3
Bold Voices - August 2017 - Cover4
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