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Background & Aim: Pain is one of the common problems in intensive care units (ICUs), and is considered a major clinical challenge due to its high prevalence and unwanted effects on morbidity if left uncontrolled. This study was conducted with the aim to critically appraise pain management templates and their effect on clinical outcomes for patients admitted to adult ICUs. Methodology: The current integrative systematic review was carried out by searching the databases Web of Knowledge, Scopus, PubMed, Cochrane and Embase from January 1, 1995 to December 31, 2018 and using keywords pain, pain threshold, pain management, analgesia, algorithms, clinical protocols, program, guidelines, and intensive care. Out of 160 retrieved articles, 14 were ultimately selected, which were analyzed based on the specific criteria of pain diagnosis and evaluation, treatment, and pain documentation and prevention. Results: In all studies, specific tools for pain diagnosis and pharmacological treatment were advised or implemented. Most studies also referred to pain reassessment or prevention, but no attention to documentation of pain management was done in any of them. NRS (numeric rating scale) and BPS (behavioral pain scale) for pain assessment in conscious and unconscious patients were considered more than any other scales. Additionally, in all studies, injectable opioids were prescribed as the first line of pain medication and there was a lack of nonpharmacological pain relief advice in all. Conclusion: Disregard for various non-pharmacological pain management methods and lack of precise documentation for the pain management need more attention. Results of this study can be a useful clinical guide to design and implement a standard pain management algorithm effective in ICUs and to improve the quality of pain management in ICUs.

Evaluating the implementation of pain management templates in adult intensive care units: A systematic review