Background: Pain in the nonverbal adult patient is often misdiagnosed and undertreated. Patients who are unable to communicate pain does not indicate that pain is not present. With the majority of critical-care patients being hemodynamically unstable leaving pain untreated can have detrimental effects on already unstable hemodynamics thus affecting patient outcomes. Research has indicated that patients who have accurate pain management with appropriate analgesia and minimal sedation can help decrease ventilator days, improve patient’s mobility, and help decrease the rate of delirium and length of stay in the intensive care unit (ICU) (Bourbonnais et al., 2016).

Aim: This benchmark project proposes a 12-week long comparison study on the effects of implementing the Critical-care Pain Observation Tool (CPOT) on nonverbal adult ICU patients with the aim of determining the effect on ventilator and sedation days, patient family pain management satisfaction scores and nurses' satisfaction score on use of the new tool.

Methods: This benchmark proposes a prospective interventional study with a before and after design implementing the CPOT in nonverbal adult ICU patients. Data gathered pre and post implementation includes average ventilation and sedation times, average length of stay, family satisfaction score on pain assessment and management, and nurse satisfaction score on the use of the CPOT.

Cost/Benefit: Hypothesized implementation costs average at $17,721.60 total, a monetary benefit of $2,192.71 for every day per patient that the CPOT lessened the length of stay, as well as freeing up ICU beds and resources needed for other critically ill patients.

Current Research Results: Current research indicates the CPOT increases the nurse’s response to pain (Asadi-Noghabi et al., 2015, Frandsen et al., 2016, Khanna et al., 2018), is shown to be quick and easy to use (Khanna et al., 2018), and facilitated communication (Bourbonnais et al., 2016). Research also indicates the CPOT increased pain medication administration (Modanloo et al., 2019, Asadi-Noghabi et al, 2015) and decreased ventilation and sedation times (Bardwell et al., 2020).

Recommendation: Based on the costs/benefits of implementation and current research results the CPOT is recommended for use in nonverbal adult patients in the ICU.

Date of publication

Winter 12-2-2020

Document Type

MSN Capstone Project



Persistent identifier



Masters of Nursing - Education