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[Standardized impartial assessment of pain in unconscious patients with the Zurich Observation Pain Assessment on a neurosurgical intensive care unit - a case report].

BACKGROUND
International studies show that the majority of patients undergoing treatment in ICUs report moderate to strong levels of pain. It has been established that undetected or insufficiently treated pain can cause severe physical and emotional distress. Therefore, early and effective pain assessment is a primary treatment goal of intensive care, which is a challenge with patients having cognitive impairment.


AIM
This article shows how using the Zurich Observation Pain Assessment (ZOPA(©)) as part of a standardized assessment can close this gap.


METHOD
An interpretive single case study evaluates the use of ZOPA(©) in nursing practice and its influence on pain management.


RESULTS
The study case involved an intensive care patient with a severe subarachnoid haemorrhage for whom a total of 126 single ZOPA(©) assessments were analyzed. A total of 19 assessments showed behavioral characteristics indicative of pain. Immediate interventions to alleviate pain were taken in three quarters of these assessments. The study ICU has used ZOPA(©) for the past five years. This unit has a standard medication procedure, so nurses can administer analgesics on an "as needed" basis and take their responsibility in implementing pain management.


CONCLUSION
This study supports the finding that ZOPA(©) can contribute to early and effective detection of pain in cognitively impaired patients, resulting in improved pain treatment.