Pain management knowledge, attitudes and clinical practice: The impact of nurses' characteristics and education

Abstract

This study examined the knowattitudes, and clinical practice of registered nurses ( N = 120) regarding paint management Data were collected from nine varied clinical units in a large, univasity-effiliaated teaching hospital to an urban area of the Northeast. Demogrohic information was also collected to explore the relationship between nurses' characteristics, including previous pain education, clinical experience, area of clinical practice, and other variables, and knowledge, attitudes and clinical practice. Three instruments mere used in the study: (a) the Pain Management Nurses' Knowledge and Attitude Survey; (b) a 12-item demographic questionnaire; and (c) a Pain Audit Tool (PAT) to gather data regarding pain assessment, documentation, and treatment practices from charts. Mean scores from the nursing knowledge and attitudes survey on pain revealed knowledge deficits and inconsistent responses in many areas related to pain management (mean, 62%; range, 41%–90%) . The top two nurse-ranked barriers to pain management were related to patient reluctance to report pain and to take opioids for pain relief. Demographic data revealed that education about pain was most inadequate in the following areas: nonpharmacological interventions to relieve pain, the difference between acute and chronic pain, and the anatomy and physiology of pain. Chart audits with the Pain Audit Tool revealed that 76% of the charts ( N = 82) lacked documentation of the use of a patient self-rating tool by nurses to assess drain, despite a high reported use (76%) of such a self rating tool Adjunct medications were ordered with some consistency but appeared to be underutilized. This was especially true of nonsteroidal anti-inflammatory agents (mean use, l %). Ninety percent of the charts had no documentation of the use of nonpharmacological interventions to relieve pain. Although this clinical setting has policies and resources in place regarding the management of pain; it would appear that they are not optimal Practical recommendations are presented for increasing nurses' knowledge about papa management; improving the quality and the consistency of the documentation and treatment of pain; and disseminating pain management information.