(212) - Barriers to adult surgical pain management

Abstract

Effective pain management can facilitate recovery and improve patient satisfaction. Nurses spend the most time with patients, and therefore, institutions must identify and alleviate perceived barriers from nursing clinicians to ultimately improve pain management. The aim of this investigation was to identify nurses' perceptions of barriers to providing optimal pain management and to also define optimal pain management. Following IRB approval, electronic invitations were sent to 289 nurses on nine general and intermediate surgical units at the University of Wisconsin Hospital. Paper surveys were available on each eligible unit during the enrollment period, and completion of the survey was voluntary, anonymous, and implied informed consent. Subjects were asked to complete the Barriers to Optimal Pain Management paper survey that was adapted by Van Hulle Vincent & Denyes, (2004) and Czarnecki et al (2011). The survey contained 33 questions. Ninety-four surveys were completed following the two scheduled reminders. Of those who responded, 98% reported that more than half of the time they are taking care of patients with pain. The majority of the respondents (84%) reported more than one component to optimal pain management and 60% reported three or more components. The most common components were patient satisfaction with pain control (80%), patient report that pain was tolerable (78%), and patient ability to complete ADLs (73%). The greatest limitation reported by nurses for managing pain, in all units, was competing demands of nursing time. The nurses on all units believe that patients report pain, however, there were statistical differences by unit of patients who refused or were reluctant to take additional pain medications and by the nurses' perception of perceived versus actual pain severity reported. This study demonstrates that competing demands of nurses may have a negative impact on the treatment of pain.