Thai Nurses' experiences of post-operative pain assessment and its' influence on pain management decisions.

Manaporn Chatchumni,Ampaporn Namvongprom,Henrik Eriksson,Monir Mazaheri

doi:10.1186/s12912-016-0136-8

Manaporn Chatchumni, Ampaporn Namvongprom + Show 2 more

Open Access

https://doi.org/10.1186/s12912-016-0136-8

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Abstract

BackgroundWhile many studies have addressed various issues with regards to pain management, there is limited knowledge about how nurses assess pain in surgical wards. This study aimed to describe Thai nurses’ experiences of pain assessment in a surgical ward.MethodsA cross-sectional explorative study was conducted. Participants were selected through theoretical sampling. Data was collected through interviews with twelve registered nurses working in surgical wards. Qualitative content analysis guided the analysis of the data.ResultsNurses use a double/triple check system, communicated to the healthcare team via records and protocols, and they used their skills and experiences in pain assessment. The results showed that nurses missed the opportunity to include the patients’ self-reported pain in their accounts. Though much evidence of pain was collected, this did not seem to benefit the patients. Furthermore, the nurses were not using instruments to measure pain, which illustrates the potential unreliability of professionals who have differing opinions concerning the patients’ pain.ConclusionsThai nurses worked based on a ‘patient-evidence’ paradigm when assessing patients in pain; this should be shifted to an evidence-based paradigm. Furthermore, by including the patients’ self-reported pain in their assessment, nurses would both improve the quality of the pain assessment and empower patients in their pain management. Pain management practices in Thailand should be improved through education, training, supportive innovation, and collegial competence development in order to improve the quality of care in the post-operative field.

Highlights

While many studies have addressed various issues with regards to pain management, there is limited knowledge about how nurses assess pain in surgical wards
Nurses play a pivotal role in assessing and monitoring pain, and the multi-method approach they used illustrated their nursing skills and ability to collect patient information and rationally integrate this information with their own pre-existing beliefs, which are derived from their own experiences in pain assessment
Future research should further examine these pain assessment procedures, focusing on ways to improve pain assessment methods and possibly develop a set of pain management guidelines, which could improve the communication of pain assessment between the nurses and the physicians in post-operative care

Summary

Introduction

While many studies have addressed various issues with regards to pain management, there is limited knowledge about how nurses assess pain in surgical wards. This study aimed to describe Thai nurses’ experiences of pain assessment in a surgical ward. Nurses play a key role in pain assessment and in advising on the standards of pain management in postoperative recovery on surgical wards. Zoëga et al [4] reported from their study in Iceland that 57 % of the patients’ documents examined demonstrated that patients had undergone pain assessment and only 27 % had documented pain severity on a standardized scale. There are many barriers that can interfere with the process of pain management. Insufficient reductions in patient suffering can result in increased complications and compromised hospital outcomes, Chatchumni et al BMC Nursing (2016) 15:12 such as an increase of readmission rate, a lengthy hospital stay, or higher costs of medical care [4, 8]

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