Share this article on:

Validation of the Critical-Care Pain Observation Tool in Adult Critically Ill Patients

Buttes, Paul MSN, RN, CNML; Keal, Ginger BSN, RN, CNML; Cronin, Sherill Nones PhD, RN, BC; Stocks, Laurel MSN, APRN, RN, CCNS; Stout, Cheryl MSN, RN, CENP

Dimensions of Critical Care Nursing: March/April 2014 - Volume 33 - Issue 2 - p 78–81
doi: 10.1097/DCC.0000000000000021
Research DIMENSION

Background: Effective management of pain begins with accurate assessment of its presence and severity, which is difficult in critically ill patients. The Critical-Care Pain Observation Tool (CPOT) was developed to evaluate behaviors associated with pain and validated primarily with cardiac surgical patients.

Objective: The purpose of this study was to examine reliability and validity of the CPOT in a general population of adult, critically ill patients.

Methods: Using a sample of 75 patients from critical care units of a community hospital, pain was evaluated at 3 times (prerepositioning, during repositioning, and postrepositioning) by 2 evaluators, using 3 different pain scales: CPOT; Faces, Legs, Activity, Cry, and Consolability (FLACC) scale; and Pain Intensity Numeric Rating Scale.

Results: Results indicated that reliability and validity of the CPOT were acceptable. Interrater reliability was supported by strong intraclass correlations (ranging from 0.74 to 0.91). For criterion-related validity, significant associations were found between CPOT scores and both FLACC (0.87-0.92) and Pain Intensity Numeric Rating Scale (0.50-0.69) scores. Discriminant validity was supported by significantly higher scores during repositioning (mean, 1.85) versus at rest (pre mean, 0.60; post mean, 0.65).

Discussion: The CPOT is an acceptable behavioral pain assessment scale for use in the general critical care patient population and is more appropriate for use with adults than the FLACC.

The purpose of this study was to examine reliability and validity of the Critical-Care Pain Observation Tool (CPOT) in a general population of adult, critically ill patients. The CPOT was developed to evaluate behaviors associated with pain and validated primarily with cardiac surgical patients. Results indicate that the CPOT is an acceptable behavioral pain assessment scale for use in the general adult critical care patient population.

Paul Buttes, MSN, RN, CNML, is nurse manager at Baptist Health Louisville, Kentucky.

Ginger Keal, BSN, RN, CNML, is nurse manager at Baptist Health Louisville, Kentucky.

Sherill Nones Cronin, PhD, RN, BC, is professor of nursing at Bellarmine University, Kentucky.

Laurel Stocks, MSN, APRN, RN, CCNS, is nurse practitioner at University of Louisville Healthcare, Kentucky.

Cheryl Stout, MSN, RN, CENP, nursing director at Baptist Health Louisville, Kentucky.

Work was performed at Baptist Health Louisville.

No financial support was received for this study.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

Address correspondence and reprint requests to: Sherill Nones Cronin, PhD, RN, BC, Bellarmine University, 2001 Newburg Rd, Louisville, KY 40205 (scronin@bellarmine.edu).

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins