Quality Pain Management in Adult Hospitalized Patients: A Concept Evaluation

Factors Relating to Nurses' Knowledge and Attitudes Regarding Pain Management in Inpatients

PURPOSE

To describe factors associated with nurses' attitudes or lack of knowledge regarding pain management in adult inpatients.

DESIGN

Transverse descriptive survey-based study.

METHODS

This was a transverse descriptive survey-based study. The population was obtained through nonprobabilistic convenience sampling. The Knowledge and Attitudes Survey Regarding Pain was made available to 470 nurses at a tertiary level hospital. Associations were sought with the unit where assigned, years of experience, specific training on pain, and postgraduate education.

RESULTS

The sample included 134 nurses with a mean age of 41.6 ± 10.8 years; 87% were women, 64% worked rotating shifts, 64% had more than 10 years of experience, and 31% had specific training in pain management. The greatest number of correct responses was obtained from nurses with specific training in pain management (p = .001) and nurses who worked in units of surgical hospitalization (p = .004). The lack of training was associated with a deficit in knowledge and inadequate attitudes about pain management. In nurses with less than 10 years of experience, worse results were observed in knowledge, whereas the unit of work was decisive in the results about attitude (p < .05).

CONCLUSIONS

Among the nurses surveyed, some knowledge gaps were detected, as were certain inappropriate attitudes, associated with lack of training, lack of experience, and being assigned to specific hospitalization units.

Prevalence, pain management and registration in Internal Medicine units

OBJECTIVE

To analyze the prevalence and management of pain episodes, their evaluation and recording in internal medicine hospitalization units in a third level public hospital of the regional health service of Castilla y León.

METHOD

A descriptive cross-sectional study. The study population comprised patients hospitalized in internal medicine units. Pain prevalence was detected by the Brief Pain Inventory questionnaire. The management of pain episodes was analyzed as recorded in the clinical records.

RESULTS

83 patients were included, 73.5% of them reported pain and 67.2% did not know their analgesia regimen. More episodes of pain were identified in the women (P=.006) than in the men. The pharmacological administration was recorded in all cases; however, nurses recorded the episode in the clinical history of 29.5% of the patients. In no case, was the pain intensity or degree of relief recorded using the visual analogical scale.

CONCLUSIONS

There is evidence of a high prevalence of pain in hospitalized patients and deficiencies in the management of pain episodes by nurses, both in evaluation and recording. This implies the need for pain control protocols and the implementation of evidence-based best practice guidelines to provide nurses with the means and support for adequate pain management.

[Pain management nursing in hospitalized patients with non-oncological diseases]

AIM

To assess pain management in patients hospitalized with a non-oncological disease and evaluate factors involved in pain assessment.

METHODS

A descriptive, cross-sectional study. We reviewed pain episodes documented in the medical records of 105 patients aged>18 years admitted to the medical units of a regional hospital between September and December 2014. Reports of pain episodes were evaluated by assessing 22 variables related to pain management quality criteria.

RESULTS

A total of 184 reports were reviewed. Pain was measured using the visual analogue scale (VAS) in 70.1% of patients (n=129); pain was reassessed in 44.3% (n=54) of patients. Pain reassessment was significantly more frequent in patients aged<70 years, as compared to older patients (53.1 vs. 26.8%, respectively; p=0.01). Pain was more frequently considered to be unrelated to the cause of admission in women as compared to men (50 vs. 25.7% p=0.027). Pain was identified in the patient care plan as a collaborative problem by the nurse for 21.1% of the patients.

CONCLUSIONS

Some aspects of pain management should be improved, especially those regarding pain description and reassessment. The age and sex of patients significantly influence the approach of pain.