• Marie-José Roos-Blom, Wouter T Gude, Jan Jaap Spijkstra, Evert de Jonge, Dave Dongelmans, and Nicolette F de Keizer.
• Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health research institute, The Netherlands; National Intensive Care Evaluation (NICE) foundation, Amsterdam, The Netherlands. Electronic address: m.blom@amc.uva.nl.
• J Crit Care. 2019 Feb 1; 49: 136-142.

PurposeTo evaluate the quality of pain assessment in Dutch ICUs and its room for improvement.Materials And MethodsWe used a modified RAND method to develop pain assessment indicators. We measured performance on the indicators using retrospectively collected pain measurement data from Dutch ICUs, which are all mixed medical - surgical, of three months within October 2016-May 2017. We assessed the room for improvement, feasibility of data collection, and reliability of the indicators.ResultsWe defined four pain assessment indicators. We analyzed 45,688 patient-shift observations from 15 ICUs. In 69.2% (IQR 58.7-84.9) of the patient-shifts pain was measured at least once (indicator 1); in 56.7% (IQR 49.6-73.5) pain scores were acceptable (indicator 2); in 11.7% (IQR 5.6-26.4) pain measurements with unacceptable scores were repeated within 1 h (indicator 3); and in 10.9% (IQR 5.1-20.1) unacceptable scores normalized within 1 h (indicator 4). We found data collection feasible because data were available for >79.3% of the admissions, and all indicators reliable as they produced consistent performance scores.ConclusionsThere is substantial variation in pain assessment across Dutch ICUs, and ample room for improvement. With this study we took a first step towards quality assurance of pain assessment in Dutch ICUs.Copyright © 2018 Elsevier Inc. All rights reserved.

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