The Clinical Supervision in Pain Management for Critical Patients

Abstract

Background: Clinical supervision underpins the management of pain in critically ill patients by training and empowering nurses in decision-making, ensuring a standard of quality care for critically ill patients. Objectives: To identify the assessment of pain in critically ill patients in an Intensive Care Unit (ICU), to define the content to be included in Clinical Supervision sessions based on the Indicator Sensitive to Clinical Supervision in Nursing (IS-SCE) Pain and to compare the assessment of pain in critically ill patients before and after clinical supervision sessions. Methods: A quasi-experimental (pre- and post-intervention) cross-sectional study of 31 nurses from an ICU in Porto. Data was collected by auditing the nursing records of 92 clinical files in November 2022 and May 2023. Statistical analysis was conducted using SPSS. Results: Pain assessment is differentiated and stratified according to medical and surgical status, and pain management combined pharmacological and non-pharmacological treatments, with gaps in reassessment after analgesia and performance of invasive procedures. Therefore, pain assessment and management were the areas identified and included in the supervisory sessions, as part of training and follow-up. There was an improvement in all the IS-SCE Pain parameters post-intervention, demonstrating an improvement in the quality of care provided to critically ill patients. Conclusion: The adoption of a structured Clinical Nursing Supervision process, including audits and training, contributes to improving pain management in critically ill patients.