Pain Management Knowledge of Registered Nurses Practicing in Acute-Care Hospitals in The Bahamas

Shane Neely-Smith, Maggie Turner, Zorene A. Curry, Theresa E. Moxey-Adderley, Constance J. Wilson, Sandra G. Smith

Abstract


Since pain is the most common complaint of the hospitalized patient, and nurses are with patients more than any other healthcare professional, it is imperative that nurses know how to adequately assess and manage patients' pain. However, findings from studies that suggested that nurses' lack of knowledge is among the primary reasons for inadequate pain management, which leads to major discomfort and decreased quality of life for patients.

A descriptive, correlational study was conducted to describe and explore the knowledge base of registered nurses practicing in acute-care hospitals in The Bahamas in regard to pain management. The "model of nursing knowledge", developed by Jacobs-Kramer and Chinn (1988) was used as the conceptual framework for this study.

The population was 247 registered nurses from three hospitals that offer acute care in The Bahamas. Data were collected via a questionnaire, which consisted of three sections: (a) six demographic items, (b) 15 multiple-choice items, and (c) 15 true or false items. Sections B and C contained items originally designed by McCaffery and Ferrell (1992), some of which were modified to reflect the pain management practices in The Bahamas. The mean pain management knowledge score was 13.5 (46.6%, se-0.20).

Findings indicated that nurses lack pain management knowledge concerning physical and behavioral indicators of pain, pain assessment principles, identification of opioids/narcotics, equianalgesia and that they believe in many myths related to pain assessment and management.

The results from this study reveal the need to develop strategies that will enhance pain management practices for the hospitalized patient to increase quality of life and patient satisfaction.

Keywords


Pain management; Nursing care - Bahamas

Full Text:

PDF

References


Ben David, Y., & Musgrave, C. F. (1996). Pain assessment: A pilot in an Israeli bone marrow transplant unit. Cancer Nursing, 19(2), 93-97. https://doi.org/ 10.1097/00002820-199604000-00002

Bowman, J. M. (1994). Perception of surgical pain by nurses and patients. Clinical Nursing Research, 3(1), 69-76. https;//doi.org/ 10.1177/105477389400300107

Calvillo, E. R., & Flaskerud, J. H. (1993). Evaluation of the pain response by Mexican American and Anglo American women and their nurses. Journal of Advanced Nursing, 18(3), 451-459. https://doi.org/ Evaluation of the pain response by Mexican American and Anglo American women and their nurses. https://doi.org/10.1046/j.1365-2648.1993.18030451.x

Camp, L. D., & O’Sullivan, P. S. (1987). Comparison of medical, surgical, and oncology patients’ descriptions of pain and nurses’ documentation of pain assessments. Journal of Advanced Nursing, 12(5), 593-598. https://doi.org/10.1111/j.1365-2648.1987.tb03049.x

Carper, B. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1(1), 13-23. https://doi.org/10.1097/00012272-197810000-00004

Chambers, C. T., Cassidy, K. L., McGrath, P. J., Gilbert, C. A., & Craig, K. D. (1996). Child facial coding system revised manual. Dalhousie University.

Dalton, J. A. (1989). Nurses’ perceptions of their pain assessment skills, pain management practices, and attitudes toward pain. Oncology Nursing Forum, 16(2), 225-231. https://pubmed.ncbi.nlm.nih.gov/2928271/

Dufault, M. A., Bielecki, C., Collins, E., & Willey, C. (1995). Changing nurses’ assessment practice: A collaborative research utilization approach. Journal of Advanced Nursing, 21(4), 634-645. https://doi.org/10.1046/j.1365-2648.1995.21040634.x

Ferrell, B. R., McCaffery, M., & Grant, M. (1991). Clinical decision making and pain. Cancer Nursing, 14(6), 289-297. https://pubmed.ncbi.nlm.nih.gov/1760801/

Ferrell, B. R., McCaffery, M., & Ropchan, R. (1992). Pain management as a clinical challenge for nursing administration. Nursing Outlook, 40(6), 263-268. https://pubmed.ncbi.nlm.nih.gov/1461757/

Gujol, M. C. (1994). A survey of pain assessment and management practices among critical care nurses. American Journal of Critical Care, 3(2), 123-128. https://doi.org/10.4037/ajcc1994.3.2.123

Harrison, A. (1991). Assessing patients’ pain: Identifying reasons for error. Journal of Advanced Nursing, 16(9), 1018-1025. https://doi.org/10.1111/j.1365-2648.1991.tb03361.x

Herr, K. A., & Mobily, P. R. (1993). Comparison of selected pain assessment tools for use with the elderly. Applied Nursing Research, 6(1), 39-46. https://doi.org/10.1016/s0897-1897(05)80041-2

Ignatavicius, D. D., Workman, M. L., & Mishler, M. A. (1999). Medical surgical nursing across the health care continuum. (3rd ed.). Saunders.

Jacobs-Kramer, M. K., & Chinn, P. L. (1988). Perspectives on knowing: A model of nursing knowledge. Scholarly Inquiry for Nursing Practice, 2(2), 129-144. https://doi.org/10.1891/0889-7182.2.2.129

Kubecka, K. E., Simon, J. M., & Boettcher, J. H. (1996). Pain management knowledge of hospital-based nurses in a rural Appalachian area. Journal of Advanced Nursing, 23(5), 861-867. https://doi.org/10.1046/j.1365-2648.1996.00951.x

McCaffery, M., & Ferrell, B. R. (1992). How vital are vital signs? Nursing, 22(1),42-46. https://pubmed.ncbi.nlm.nih.gov/1741085/

McCaffery, M., Ferrell, B., O’Neil-Page, E., & Lester, M. (1990). Nurses’ knowledge of opioid analgesic drugs and psychological dependence. Cancer Nursing, 13(1), 21-27. https://pubmed.ncbi.nlm.nih.gov/2306717/

McDonald, D., McNulty, J., Erickson, K., & Weiskopf, C. (2000). Communicating pain and pain management needs after surgery. Applied Nursing Research,13(2), 70-75. https://doi.org/10.1016/s0897-1897(00)80003-8

Nash, R., Edwards, H., & Nebauer, M. (1993). Effect of attitudes, subjective norms and perceived control in nurses’ intention to assess patients’ pain. Journal of Advanced Nursing, 18(6), 941-947. https://doi.org/10.1046/j.1365-2648.1993.18060941.x

Phillips, D. M. (2000). JCAHO pain management standards are unveiled. Journal of the American Medical Association, 248(4), 428-429. https://doi.org/10.1001/jama.284.4.423b

Rutledge, D. N., & Donaldson, N. E. (1998a). Pain assessment and documentation, Part 1: Overview and application in adults. Online Journal of Clinical Innovations, 1(5), 1-37.

Rutledge, D. N., & Donaldson, N. E. (1998b). Pain assessment and documentation, Part 2: Special populations of adults. Online Journal of Clinical Innovations, 1(6), 1-29.

Simons, W., & Malabar, R. (1995). Assessing pain in elderly patients who cannot respond verbally. Journal of Advanced Nursing, 22(4), 663-669. https://doi.org/10.1046/j.1365-2648.1995.22040663.x

Wells, N. (1984). Responses to acute pain and the nursing implications. Journal of Advanced Nursing, 9(1), 51-58. https://doi.org/10.1111/j.1365-2648.1984.tb00343.x

White, C. L. (1999). Changing pain management practice and impacting on patient outcomes. Clinical Nurse Specialist, 13(4), 166-72. https://doi.org/10.1097/00002800-199907000-00005

Willson, H. (2000). Factors affecting the administration of analgesia in patients following repair of fractured hip. Journal of Advanced Nursing, 31(5), 1145-1154. https://doi.org/10.1046/j.1365-2648.2000.01425.x

Yates, P., Dewar, A., Edwards, H., Fentiman, B., Najman, J., Nash, R., Richardson, V., & Fraser, J. (1998). The prevalence and perception of pain amongst hospital inpatients. Journal of Clinical Nursing, 7(6), 521-530. https://doi.org/10.1046/j.1365-2702.1998.00192.x




DOI: http://dx.doi.org/10.15362/ijbs.v12i0.51

Copyright (c) 2003 S. Neely-Smith, M. Turner, Z.A. Curry, T.E. Moxey-Adderley, C.J. Wilson & S.G. Smith