When addressing pain management in critically ill patients do you consistently use a self-report scale for those patients who can communicate? How about using a behavioral pain assessment scale for patients who are nonverbal? Rose and colleagues asked this of 802 Canadian intensive care unit (ICU) nurses and found the following:

Although most nurses indicated it was important to assess pain in all ICU patients, actual use of a pain tool for nonverbal patients was infrequent. This parallels the reported lack of knowledge regarding the existence of published pain assessment and management guidelines.

—Rochele Armola,rn, msn, ccrn

See Article, pp 251–259

Controlling glucose levels is usually achieved by following specific physician orders, fixed paper protocols or computer based nomograms. “Fall outs” from target glucose ranges can occur with these methods. Despite diligent management, maintaining target ranges in critically ill patients is difficult...

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