{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:35:57Z","timestamp":1760060157016,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Surgeries"],"abstract":"<jats:p>Background: Pain is a problem faced by critically ill surgical patients and has a major impact on their outcomes. Pain assessment is therefore essential for effective pain management, with a combination of pharmacological and non-pharmacological treatment. Clinical supervision, supported by models such as SafeCare, can improve professional development, safety and the quality of care in intensive care units. Objectives: This study aimed to: (1) assess current pain assessment practices in a polyvalent Intensive Care Unit (ICU) in the Porto district; (2) identify nurses\u2019 training needs regarding the Clinical Supervision-Sensitive Indicator\u2014Pain; and (3) evaluate the impact of clinical supervision sessions on pain assessment practices. Methods: A quantitative, quasi-experimental, cross-sectional study with a pre- and post-intervention design was conducted. Based on the SafeCare model, it included a situational diagnosis, 6 clinical supervision sessions (February 2023), and outcome evaluation via nursing record audits (November 2022 and May 2023) in 31 total critical ill patients. Pain was assessed using standardised tools, in line with institutional protocols. Data was analysed using Software Statistical Package for the Social Sciences v25.0. Results: Pain was highly prevalent in the first 24 h, decreasing during hospitalisation. Generalised acute abdominal pain predominated, with mild to moderate intensity, and was exacerbated by wound care and mobilisation\/positioning. Pain management combined pharmacological and non-pharmacological treatment. There was an improvement in all the parameters of the pain indicator post-intervention. Conclusions: Despite routine assessments, gaps remained in reassessing pain post-analgesia and during invasive procedures. Targeted clinical supervision and ongoing training proved effective in improving compliance with protocols and supporting safer, more consistent pain management.<\/jats:p>","DOI":"10.3390\/surgeries6030067","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T10:50:21Z","timestamp":1754391021000},"page":"67","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving Pain Management in Critically Ill Surgical Patients: The Impact of Clinical Supervision"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8917-6741","authenticated-orcid":false,"given":"Telma","family":"Coelho","sequence":"first","affiliation":[{"name":"Local Health Unit of T\u00e2mega and Sousa (ULS T\u00e2mega e Sousa), 4560-136 Guilhufe, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7602-1313","authenticated-orcid":false,"given":"Diana","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"RISE-Health, Faculty of Medicine, University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Nursing School of Porto, Rua Dr. Ant\u00f3nio Bernardino de Almeida, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6077-4150","authenticated-orcid":false,"given":"Cristina Barroso","family":"Pinto","sequence":"additional","affiliation":[{"name":"RISE-Health, Faculty of Medicine, University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Nursing School of Porto, Rua Dr. Ant\u00f3nio Bernardino de Almeida, 4200-072 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.2147\/JPR.S256406","article-title":"Current perspectives on the assessment and management of pain in the intensive care unit","volume":"14","author":"Nordness","year":"2021","journal-title":"J. Pain. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"475","DOI":"10.5005\/jp-journals-10071-24154","article-title":"Diagnostic Values of the Critical Care Pain Observation Tool and the Behavioral Pain Scale for Pain Assessment among Unconscious Patients: A Comparative Study","volume":"26","author":"Nazari","year":"2022","journal-title":"Indian J. Crit. Care Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1007\/s00134-022-06807-w","article-title":"Monitoring pain in the intensive care unit (ICU)","volume":"48","author":"Chanques","year":"2022","journal-title":"Intensiv. Care Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s40122-022-00366-0","article-title":"Pain in intensive care: A narrative review","volume":"11","author":"Pota","year":"2022","journal-title":"Pain Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1097\/TA.0000000000004154","article-title":"Optimal strategies for assessing and managing pain, agitation, and delirium in the critically ill surgical patient: What you need to know","volume":"96","author":"Evans","year":"2024","journal-title":"J. Trauma. Acute Care Surg."},{"key":"ref_6","first-page":"11","article-title":"Exploring Clinical Supervision Model employed by Qualified Nursing Staff at Mbarara Regional Referral Hospital and its Contribution to Students\u2019 Competencies","volume":"2","author":"Opio","year":"2021","journal-title":"Stud. J. Health Res. Afr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"69","DOI":"10.32598\/JCCNC.8.2.426.1","article-title":"How Effective is Clinical Supervision in Nursing? A Systematic Review","volume":"8","author":"Ernawati","year":"2022","journal-title":"J. Client-Centered Nurs. Care"},{"key":"ref_8","unstructured":"Cruz, S. (2012). From Ad Hoc to a Model of Clinical Supervision in Nursing in Use. [Ph.D. Thesis, Universidade Cat\u00f3lica Portuguesa]. Available online: http:\/\/hdl.handle.net\/10400.14\/12619."},{"key":"ref_9","unstructured":"Carvalho, A.L., and Barroso, C. (2019). Safecare Model: Contextualized model of clinical supervision in nursing. Implementation of a Model of Clinical Supervision in Nursing\u2014Practical Manual, Uniarte Gr\u00e1fica. Available online: https:\/\/comum.rcaap.pt\/bitstream\/10400.26\/31966\/1\/SafeCare-EBook10-19.pdf."},{"key":"ref_10","unstructured":"Carvalho, L., Barroso, C., Pereira, M., Teixeira, A., Pinho, F., and Os\u00f3rio, M. (2019). Implementation of a Clinical Supervision Model in Nursing\u2014Practical Manual, Uniarte Gr\u00e1fica. Available online: http:\/\/hdl.handle.net\/10400.26\/31971."},{"key":"ref_11","unstructured":"Rua, F. (2020). Intensive Care: From the past to the Future. J. A. Pinho. Intensive Care Nursing, Lidel\u2013Edi\u00e7\u00f5es T\u00e9cnicas, Lda."},{"key":"ref_12","first-page":"99","article-title":"Percepci\u00f3n del dolor de los pacientes posquir\u00fargicos en una unidad de cuidados intensivos. Sociedad Espa\u00f1ola de Enfermer\u00eda Intensiva y Unidades Coronarias (SEEIUC)","volume":"30","year":"2019","journal-title":"Elsevier Espa\u00f1a"},{"key":"ref_13","first-page":"100124","article-title":"Surgery patients\u2019 perspectives of their role in postoperative pain: A scoping reviewInt","volume":"5","author":"Walton","year":"2023","journal-title":"J. Nurs. Stud. Adv."},{"key":"ref_14","first-page":"1","article-title":"Pain assessment in adult intensive care","volume":"36","author":"Bambi","year":"2019","journal-title":"Scenar. Il Nurs. Nella Sopravvivenza"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"104002","DOI":"10.1016\/j.iccn.2025.104002","article-title":"Occurrence rate and risk factors for rest and procedural pain in critically ill patients: A systematic review and meta-analysis","volume":"88","author":"Herlianita","year":"2025","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1097\/CCM.0000000000003299","article-title":"Clinical practice guidelines for the prevention and management of pain, agitation\/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU","volume":"46","author":"Devlin","year":"2018","journal-title":"Crit. Care Med."},{"key":"ref_17","first-page":"233","article-title":"Pain Assessment and Management for intensive care unit patients\u2014Seeking best practices","volume":"16","author":"Puntillo","year":"2016","journal-title":"ICU Manag. Pract."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3475","DOI":"10.2147\/JPR.S332423","article-title":"Nurses\u2019 perceived barriers to and facilitators of pain assessment and management in critical care patients: A systematic review","volume":"14","author":"Rababa","year":"2021","journal-title":"J. Pain Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1111\/jocn.15194","article-title":"Pain Relief Nonpharmacological Interv. Intensive Care Unit: A Scoping review","volume":"29","author":"Sandvik","year":"2020","journal-title":"J. Clin. Nurs."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/j.pmn.2022.03.002","article-title":"Assessment of Procedural Pain in Patients with COVID-19 in the Intensive Care Unit","volume":"23","author":"Erden","year":"2022","journal-title":"Pain Manag. Nurs."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1111\/wrr.12553","article-title":"Factors associated with high pain intensity during wound care procedures: A model","volume":"25","author":"Gardner","year":"2018","journal-title":"Wound Repair. Regen."},{"key":"ref_22","unstructured":"Augusto, C. (2020). Contributo da Implementa\u00e7\u00e3o da Supervis\u00e3o Cl\u00ednica em Enfermagem para a Qualidade dos Cuidados. [Ph.D. Thesis, Instituo de ci\u00eancias Biom\u00e9dicas Abel Salazar, University of Porto]. Available online: https:\/\/hdl.handle.net\/10216\/133881."}],"container-title":["Surgeries"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2673-4095\/6\/3\/67\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:22:39Z","timestamp":1760034159000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2673-4095\/6\/3\/67"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,4]]},"references-count":22,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["surgeries6030067"],"URL":"https:\/\/doi.org\/10.3390\/surgeries6030067","relation":{},"ISSN":["2673-4095"],"issn-type":[{"type":"electronic","value":"2673-4095"}],"subject":[],"published":{"date-parts":[[2025,8,4]]}}}