Nurses’ Use of the Critical Care Pain Observation Tool (CPOT) on Patients in the Intensive Care Units of the National Referral Hospital in Tanzania

Abstract

Background: Self-reporting which is the most reliable indicator of pain, is not possible to achieve in critically ill patients. Therefore, it is important to have a valid, reliable, and accurate pain assessment tool that can be used as a standard for patients unable to self-report. One such tool that has been recommended as highly valid and reliable by various critical care organizations is the Critical Care Pain Observation Tool (CPOT) Objective: To assess nurses’ knowledge and perception on feasibility of the CPOT among patients unable to self-report pain in the ICU’s of the National Referral Hospital Methodology: Single-group pretest posttest study involving 111 nurses working across six ICU’s of the National Referral Hospital of Tanzania. Two questionnaires were administered to the participants, pre and post intervention, the CPOT was introduced and its correct usage taught in form of a training as an intervention. Data was analyzed using the SPSS 25.0 software with the help of descriptive statistics as well as inferential statistics. Results: Only 20% of the respondents knew of the existence of the CPOT. Of them, only 50% reported to have used it on their patients, majority of who (63.6%) had inadequate knowledge on its appropriate use. There was however, significant improvement in their knowledge on the use of the CPOT after training (p value 0.001). Respondents perceived the CPOT as being a feasible tool for use in their current setting. Conclusion: Majority of the respondents didn’t know of the existence of the CPOT and relied on physiological parameters to assess pain. After the tool was introduced, the respondents’ knowledge on its appropriate usage was adequate and they perceived it as a feasible tool. They expressed the need of having a standard tool for routine pain assessment. Recommendations: Continuous professional education on pain assessment is required across all ICU’s for nurses and also needs to be incorporated into nursing curriculums at universities. Follow up studies are required to assess nurses implementation of the CPOT. Recommendations can then be made to create standard pain assessment policies.