Emergency Department Nurses' Perceptions of Pain Management

Thursday, 15 July 2010

Ptlene Minick, PhD
Nursing, Georgia State University, Atlanta, GA

Learning Objective 1: identify nurses' perceptions of factors associated with barriers to adequate pain management.

Learning Objective 2: discuss specific strategies that may be used to develop an intervention to improve pain management practices.

The under treatment of pain in the emergency department (ED) is so pervasive that the term, “oligoanalgesia” was developed to describe the phenomenon. Despite numerous efforts to improve pain management, the under treatment of pain remains a major problem. In some settings, blacks and other minorities are less likely than whites to be medicated for pain. Because nurses conduct the initial pain assessment in the ED, obtain medical orders for medications, and administer pain medications, they have an essential role in reducing unnecessary suffering.

Purpose: The specific aim of this qualitative study is to describe ED nurses’ perceptions of pain management. What are ED nurses’ perceptions regarding adequate pain management? What factors are associated with adequate pain management? What factors are associated with barriers of adequate pain management? What strategies can be used to improve pain management in a busy ED?

Methods: A descriptive/interpretive method was chosen as the most appropriate method to reveal this complex phenomenon. Registered nurses with 6 months or more experience in the ED are being recruited. Semi-structured interviews are being conducted with the initial question of, “Tell me about a time when you managed a patient in the Emergency Department who was experiencing pain.” Prompts include, “What seems to stand out for you in this particular situation?” Data collection will continue until saturation is achieved. Approximately 15-20 interviews are anticipated. Interviews are being transcribed verbatim and loaded into Nvivo© for data management. A constant comparative analysis is being conducted by coding, categorizing, and identifying themes.

Results: Preliminary data indicate that adequate pain management in a busy ED is complex, yet nurses perceive that interventions can be developed to change current practices.

Conclusion: The findings are being used to develop interventions to improve pain management practices of ED nurses.