Q: My facility will be starting to use the Critical-Care Pain Observation Tool (CPOT) in the next month. We currently titrate the dosages of our infused pain medications to meet the goal of a score of 0 to 2 on a nonverbal pain scale. I need to put a goal for the CPOT on our pain doctor’s order form—do you have a suggestion? I know that if the patient were verbal, I would be using the patient’s acceptable level of pain as the goal.

A: Caroline Arbour, RN, BSc, and Céline Gélinas, RN, PhD, reply:

The implementation of a newly developed behavioral pain assessment tool for nonverbal patients often provides the opportunity for the revision of pain management protocols in critical care settings. An issue often encountered by clinicians when revising such protocols is the establishment of directives (eg, cutoff pain score) related to the use of the new pain...

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