Nurses' pain assessment practices with critically ill adult patients

Kizza, Irene Betty; Muliira, Joshua Kanaabi

doi:10.1111/inr.12218

Cited by 35 publications

(43 citation statements)

References 40 publications

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“…Critically ill patients may suffer from a multitude of neurological, physiological and communicative disabilities arising from a variety of reasons, which may be further complicated by intubation and use of sedatives (Kizza & Muliira, 2015). Inappropriate diagnosis and management of acute pain may lead to increased morbidity and mortality (Auvray, Myin, & Spence, 2010; Lord & Varndell, 2019; Schug, Palmer, Scott, Halliwell, & Trinca, 2015).…”

Section: Discussionmentioning

confidence: 99%

Pain assessment and interventions by nurses in the emergency department: A national survey

Varndell

Fry

Elliott

2020

Journal of Clinical Nursing

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Aim The aim of this study was to examine the knowledge, perceptions and factors influencing pain assessment and management practices among Australian emergency nurses. Background Pain is the most commonly reported symptom in patients presenting to the emergency department, with over half rating their pain as moderate‐to‐severe. Patients unable to communicate, such as critically ill intubated patients, are at greater risk of inadequate pain management. Design This cross‐sectional exploratory study used survey methodology to explore knowledge, perceptions and factors influencing pain management practices among Australian emergency nurses. Methods Australian emergency nurses were invited to complete an online survey comprising 91 items. The response rate was 450 of 1,488 (30.2%). STROBE guidelines were used in reporting this study. Results Variations in level of acute pain management knowledge, especially in older, cognitively impaired or mechanically ventilated patients were identified. Poor interprofessional communication, workload and staffing negatively impacted on nurses’ intention to administer analgesia. For intubated patients, validated observation pain assessment instruments were rarely used, although respondents recognised the importance of pain management in critically ill patients. Conclusions Emergency nurses recognise the importance of pain relief. The ability to nurse‐initiate analgesia, education and training in pain management education is variable. Little education is provided on assessing and managing acute pain in elderly, cognitively impaired or mechanically ventilated patients. Use of validated pain assessment instruments to assess pain in critically ill patients is poor. Relevance to clinical practice While pain management is the responsibility of all healthcare professionals, in the emergency department, it is a core role of emergency nursing. This study highlights the variation in ability to nurse‐initiate analgesia, level of acute pain knowledge, education and training, and use of validated pain assessment instruments to guide pain management in critically ill intubated patients.

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Section: Discussionmentioning

confidence: 99%

Pain assessment and interventions by nurses in the emergency department: A national survey

Varndell

Fry

Elliott

2020

Journal of Clinical Nursing

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“…For example, acute pain was identified as the most frequently used nursing diagnoses in the SICU and CVICU. This result is reasonable because critically ill patients admitted to the ICU experience significant pain due to reasons related to their disease, surgery, and routine care such as turning and suctioning (Kizza & Muliira, ; Stites & Surprise, ). However, degree centrality revealed a difference between the two units.…”

Section: Discussionmentioning

confidence: 99%

Identifying Nursing Diagnosis Patterns in Three Intensive Care Units Using Network Analysis

Moon

2018

Int J of Nursing Knowl

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PURPOSE This study aimed to analyze the patterns of nursing diagnoses used in three different types of intensive care units (ICUs) using network analysis. METHODS A secondary analysis was conducted using clinical datasets of 582 patients. Frequency, degree/betweenness centrality, and subgroup analysis were performed. FINDINGS AND CONCLUSIONS The findings illuminated core nursing diagnoses with high centrality as well as high frequency. The centrality analysis identified the differences between and unique characteristics of each ICU. The subgroup analysis revealed the nursing problem groups related to the specific nursing care delivered to ICU patients. IMPLICATIONS FOR NURSING PRACTICE Theses results provide a knowledge base to aid ICU nurses' prompt decision making regarding nursing diagnoses.

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“…According to the reported results, only a small number of nurses provide appropriate care when the patient is experiencing pain. However, they have a moral responsibility to provide the best clinical care in pain relief (25). The nurses' awareness and attitude play an important role in the implementation of an effective pain management process (26) and the results of previous studies showed that training programs in the field of pain significantly enhance the nurses' knowledge and attitude toward pain (27,28).…”

Section: Introductionmentioning

confidence: 99%

Effect of Comprehensive Pain Management Training Program on Awareness and Attitude of ICU Nurses

et al. 2020

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Background: Pain is one of the main complaints of many patients in intensive care units. However, most nurses and physicians are unable to properly monitor and relieve pain in these patients. Factors such as patients' inability to describe their pain and insufficient knowledge of nurses and physicians have made pain management difficult. Given that the knowledge and attitude of nurses play an important role in the effective implementation of the pain management process, this study aimed to investigate the effect of comprehensive pain management training program on the awareness and attitude of intensive care unit nurses. Methods: This quasi-experimental single-group study was conducted in two phases (pre and post-intervention) to investigate the awareness and attitude of all nurses employed in the intensive care unit of Tehran Modarres Hospital, based on the determined inclusion and exclusion criteria. In the pre-intervention phase, the awareness and attitudes of the nurses were assessed using a questionnaire. After conducting the pain management training course, an executive program and algorithm were implemented for pain management in ICUs. Then, the nurses' awareness and attitude toward pain management were assessed again. Finally, changes in the scores of the nurses' awareness and attitude were analyzed by SPSS V. 22 software in two phases before and after applying the interventions using the Wilcoxon test. The relationship between some demographic variables and the level of awareness and attitude of nurses was also investigated using the Kruskal-Wallis and Mann-Whitney tests. Results: The results of this study indicated that the mean score of the nurses' awareness was significantly different in pre-and postintervention phases (P < 0.05). Despite an increase in the post-intervention mean score of the nurses' attitude (71.03), no statistically significant change was observed. Additionally, among the demographic variables, there was only a significant relationship between the nurses' job experience in ICUs and their attitudes. Conclusions: Based on the results of this study, teaching and implementing a comprehensive program for pain management can play an effective role in promoting the nurses' awareness. Therefore, it is proposed to use pain management models to improve the nurses' knowledge and attitude toward pain management in ICU patients.

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Nurses' pain assessment practices with critically ill adult patients

Abstract: Interventions to reduce barriers and enhance enablers of acute pain assessment are needed to improve pain management in critically ill adult patients. To be effective, the interventions have to be holistic and implemented by professional bodies and employers of nurses.

Cited by 35 publications

References 40 publications

Pain assessment and interventions by nurses in the emergency department: A national survey

Pain assessment and interventions by nurses in the emergency department: A national survey

Identifying Nursing Diagnosis Patterns in Three Intensive Care Units Using Network Analysis

Effect of Comprehensive Pain Management Training Program on Awareness and Attitude of ICU Nurses

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