ReviewCureus2026
Pain Management Frameworks and Critical Care Nursing Competencies: An Evidence-Informed Integrative Review.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pain is a prevalent and complex challenge in intensive care units (ICUs). Although structured pain management frameworks, such as validated behavioral assessment tools and multimodal analgesia protocols, are widely recommended, implementation variability persists. Emerging evidence suggests that nursing competency and organizational context influence the fidelity of these frameworks. This review synthesized contemporary literature examining ICU pain management frameworks and the nursing competencies required for effective implementation. An evidence-informed integrative review was conducted using a structured search of PubMed, CINAHL, EMBASE, Cochrane Library, and PsycINFO for studies published between January 2020 and March 2025. Empirical, validation, and guideline-based studies conducted in adult ICUs were included. The literature search yielded 10 studies, and data were extracted and thematically synthesized to identify pain management frameworks, nursing competency domains, and contextual determinants influencing practice. Findings indicate that ICU pain management is structured around validated behavioral assessment tools, including the Behavioral Pain Scale and the Critical-Care Pain Observation Tool, multimodal analgesia strategies, and protocol-driven monitoring. However, evidence demonstrates variability in nurses' pharmacological knowledge, assessment proficiency, clinical decision-making behaviors, and attitudes toward analgesia. Organizational factors, including workload pressures, staffing and patient factors, and institutional protocol reinforcement, moderate implementation consistency. The synthesis informed a three-level conceptual model linking frameworks, competency domains, and organizational determinants. Effective ICU pain management requires alignment between standardized frameworks, multidimensional nursing competencies, and supportive organizational systems. Integrated competency development and protocol reinforcement may enhance consistency and improve patient outcomes in critical care settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.