Guideline (e.g. clarity of the recommendation, accessibility)
|
60 (40)
|
36.4 (27.3)
|
Revise pain protocol about pain monitoring (e.g. frequency, triggers)
|
40 (20)
|
9.1 (0)
|
Workflow redesign; introduce routine to measuring pain
|
20 (20)
|
9.1 (9.1)
|
Increase protocol accessibility (e.g. electronically, flow chart, pocket card)
|
20 (10)
|
9.1 (9.1)
|
Develop pain protocol
|
20 (10)
|
–
|
Revise pain protocol about pain medication (e.g. drug choice, dosage choice)
|
10 (10)
|
27.3 (18.2)
|
Workflow redesign; check contraindications to pain medications at admission
|
10 (0)
|
–
|
Individual health professional (e.g. knowledge and skills; cognitions)
|
90 (70)
|
81.8 (63.6)
|
Digital newsletter or email
|
70 (60)
|
27.3 (27.3)
|
Educational meeting
|
70 (50)
|
9.1 (9.1)
|
Individual feedback if pain has not been measured
|
60 (20)
|
9.1 (9.1)
|
Promotional poster or message board
|
40 (30)
|
36.4 (27.3)
|
Announcement about pain monitoring during regular staff meeting*
|
10 (0)
|
72.7 (63.6)
|
Quiz about ICU pain management knowledge*
|
–
|
9.1 (9.1)
|
Professional interactions (e.g. communication and influence; team processes)
|
30 (10)
|
9.1 (9.1)
|
Include information on pain status to hand-over moments during shift change
|
20 (0)
|
9.1 (9.1)
|
Collaborate with Acute Pain Service about pain medication after surgery*
|
10 (10)
|
–
|
Incentives and resources (e.g. availability of resources; information system)
|
100 (80)
|
63.6 (36.4)
|
Build or adapt reminder system in the EHR
|
80 (50)
|
36.4 (18.2)
|
Increase completeness of pain measurement data recording in the local EHR
|
50 (30)
|
–
|
Expand order set in EHR (e.g. add pain measurement order at admission)*
|
40 (40)
|
18.2 (9.1)
|
Provide validated pain measurement tools (i.e. NRS, VAS, BPS, CPOT)
|
30 (20)
|
–
|
Adapt EHR form to facilitate pain measurement recording*
|
10 (10)
|
18.2 (9.1)
|
Create performance monitoring tool/dashboard*
|
10 (0)
|
9.1 (0)
|
Nonfinancial incentives (e.g. edible treat) if targets are achieved*
|
–
|
9.1 (9.1)
|
Keep patient-controlled analgesia (PCA) pumps in stock locally at ICU*
|
–
|
9.1 (0)
|
Capacity for organisational change (e.g. mandate, authority, accountability)
|
40 (40)
|
27.3 (18.2)
|
Assign or involve a pain coordinator
|
40 (40)
|
18.2 (9.1)
|
Workflow redesign; increase efficiency to allow more time for measuring pain
|
10 (10)
|
–
|
Expand pain management QI team*
|
10 (10)
|
–
|
Monitoring and feedback on (recording of) pain measurements each shift*
|
10 (0)
|
9.1 (9.1)
|
Monitoring and feedback on appropriateness of prescribed pain medication
|
10 (0)
|
–
|
Patient (e.g. patient needs; preferences)
|
30 (10)
|
–
|
Workflow redesign; monitor/manage factors (e.g. fear) that may worsen pain
|
20 (0)
|
–
|
Workflow redesign; measure pain on patients’ indication
|
10 (10)
|
–
|