A survey on pain assessment in patients with disorders of consciousness in Dutch hospitals and nursing homes

The extent of variation in the use of behavioural pain observation tools, documentation and pain protocols in patients with acquired brain injury (ABI) and with disorders of consciousness (DOC) is unknown. A national survey was undertaken in Dutch hospitals with neurology and neurosurgery nursing wards and nursing homes. From 43 facilities (35 hospital wards, 8 nursing homes), 106 surveys were analysed; completion/participation rate was 88% and 40% respectively. Some 16% of the facilities used a behavioural pain observation tool. This was more often in general hospitals (24%) than in university hospitals (10%) or nursing homes (0%). Variation in measuring/observing pain could be assumed in 72% of facilities and variation in documentation in 88%. A specific pain protocol was used in 14% of the facilities. This study shows an undesirable variation in pain management in ABI patients with DOC, which should be addressed in the future to enhance quality of car