Supervisão Clínica e Gestão da Dor no Doente Crítico em Cuidados Intensivos

Abstract

Introduction: Clinical supervision in nursing is important for ensuring the quality and care safety, especially in high-complexity settings. Pain is a common symptom in critically ill patients that requires rigorous assessment and effective management through a blend of pharmacological and non-pharmacological treatments. Objectives: Identify the assessment of pain in critically ill patients in an Intensive Care Unit (ICU) and define the content to be integrated into Clinical Supervision sessions based on the Pain Indicator Sensitive to Clinical Supervision in Nursing. Material and Methods: Descriptive and cross-sectional study was conducted with 31 nurses from an ICU in Porto. Data were collected through audits of nursing records from 46 clinical cases in November 2022. Statistical analysis was performed using SPSS. Results: Pain was identified in 26.1% of patients within the first 24 hours, with higher incidence in surgical patients. Pain prevalence was 19.4% at 48 hours, 12.5% at 72 hours, and 35.7% after 72 hours. Acute generalized and abdominal pain were predominant, with intensity ranging from mild to moderate, exacerbated by mobilization/positioning. Pain management shared pharmacological and non-pharmacological treatments, with faults in re-evaluation after analgesia and invasive procedures. Conclusion: Pain is frequent in the initial days of ICU admission. Despite frequent initial assessments, there is a need to improve re-evaluation after analgesia and invasive procedures. Clinical supervision in nursing can significantly contribute to effective pain management.