Pain management interventions of the non‐communicating patient in intensive care: What works for whom and why? A rapid realist review

Abstract

AbstractAimThe utility and uptake of pain management interventions across intensive care settings is inconsistent. A rapid realist review was conducted to synthesise the evidence for the purpose of theory building and refinement.DesignA five‐step iterative process was employed to develop project scope/ research questions, collate evidence, appraise literature, synthesise evidence and interpret information from data sources.MethodsRealist synthesis method was employed to systematically review literature for developing a programme theory.Data SourcesInitial searches were undertaken in three electronic databases: MEDLINE, CINHAL and OVID. The review was supplemented with key articles from bibliographic search of identified articles. The first 200 hits from Google Scholar were screened.ResultsThree action‐oriented themes emerged as integral to successful implementation of pain management interventions. These included health facility actions, unit/team leader actions and individual nurses' actions.ConclusionPain assessment interventions are influenced by a constellation of factors which trigger mechanisms yielding effective implementation outcomes.ImplicationsThe results have implications on policy makers, health organisations, nursing teams and nurses concerned with optimising the successful implementation of pain management interventions.ImpactThe review enabled formation of a programme theory concerned with explaining how to effectively implement pain management interventions in intensive care.Reporting MethodThis review was informed by RAMESES publication standards for realist synthesis.Public ContributionNo patient or public contribution.The study protocol was registered in Open Science Framework. 10.17605/OSF.IO/J7AEZ